Cantare Registration Form Chorister's Name* First Last Chorister's Date of Birth* Date Format: MM slash DD slash YYYY Chorister's Age*Please enter a number from 7 to 11.Chorister's Race (optional, used for grant information)American Indian/Alaskan NativeAsianBlack/African-AmercanHispanic/LatinoNative Hawaiian/Pacific IslanderWhite-not HispanicParent/Guardian InformationParent/Guardian Name 1* First Last Parent/Guardian Name 2 First Last Parent/Guardian 1 Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Parent/Guardian 2 Address (If this address is the same as Parent/Guardian 1 ignore this field.) Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Parent/Guardian 1 Email* Enter Email Confirm Email Parent/Guardian 2 Email Parent/Guardian 1 Phone*Parent/Guardian 2 PhoneFinancial Responsibility*Both parents/guardiansOnly one parent/guardianIf chorister's parents are divorced, who is financially responsible for choir related expenses? Your answer will affect who is included on communications regarding financial matters.If only 1 parent/guardian, which one?School InformationSchool Name (Fall 2020)*Grade (Fall 2020)*Please enter a number from 2 to 5.School Music Teacher's NameDoes your child take private lessons? Singing Acting Dance Instrument If plays instrument, which one?Private Lesson Teacher and Contact Information Enter Email Confirm Email Do you (parent/guardian) play an instrument well enough to perform during a concert with the choir and would be willing to do so?YesNoIf so, which instrument?UniformsPolo Shirt: If we should be able to be in person at some point this year, will your chorister need a new polo shirt this season?*YesNoFor returning choristers who need a new shirt, what size is his/her current shirt?Extra SmallSmallMediumLargeExtra LargePublicityMember Directory*Include us in the DirectoryDo not include us in the DirectoryInclude us, but exclude the following information listed belowDCC distributes a Member Directory at the beginning of each year for member use only, which includes contact and school information to assist with communication between members.Excluded Information in DirectoryPublicity Release*Yes, I give my permissionNo, I do not give my permissionI give my permission to DCC to use my child's photo to help promote the choir in print, such as program brochures, performance programs, DCC website, Facebook, Instagram and any future DCC publications. Full names of children will never appear along with photos in print or on the website. Medical InformationPhysician/Pediatrician's Name*Physician/Pediatrician's Phone Number*Emergency Contact Name* First Last in case neither parent/guardian can be reachedEmergency Contact Relationship to Chorister*Emergency Contact Phone Number*Emergency Contact Phone Number 2Please list any special health problems or considerationsincluding routine medications, allergies, etc.With supervision, my child may be given the following over-the-counter medications for minor ailments* Acetaminophen (Tylenol) Ibprofen (Advil) Tums Do not give my child any medication Medical InsuranceSubscriber Name* First Last Relationship to Chorister*Insurance Company*Insurance Company Phone Number*Group Policy Number*Subscriber ID*PaymentSelect a payment option*Registration Fee and 1/2 Annual TuitionRegistration Fee and Full Annual TuitionPay by checkPlease Note - Payment by Credit Card: the fee below reflects the payment amount plus the associated processing fee. Payment by Check: your registration will not be complete until payment is received - Registration Fee plus 1/2 Tuition = $125; Registration Fee plus Full Tuition = $200. Please mail check to DCC, PO Box 61334, Durham, NC 27705. Total $0.00 The Durham Children's Choir is supported by generous grants from: Our choir is supported by the Durham Arts Council's Annual Arts Fund and the N.C. Arts Council, a division of the Department of Natural & Cultural Resources.