Cantare Registration Form Chorister's Name* First Last Name preferred if other than listed above Chorister's Date of Birth* MM slash DD slash YYYY Chorister's Race (used for grant information)* American Indian/Alaskan Native Asian Black/African-American Hispanic/Latino Native Hawaiian/Pacific Islander White-not Hispanic Decline Parent/Guardian InformationParent/Guardian Name 1* First Last Parent/Guardian Name 2 First Last Parent/Guardian 1 Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest 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 AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Parent/Guardian 1 Email* Enter Email Confirm Email Parent/Guardian 2 Email Enter Email Confirm Email Parent/Guardian 1 Phone*Parent/Guardian 2 PhoneFinancial Responsibility* Both parents/guardians Only one parent/guardian If 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 2022)* Grade (Fall 2022)*Please enter a number from 2 to 5.School Music Teacher's Name Does your child take private lessons? Singing Acting Dance Instrument If the chorister plays an 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 you be willing to do so? Yes No If so, which instrument? UniformsIf you have a returning chorister, do they need a new polo shirt? Yes No PublicityMember Directory* Include us in the Directory Do not include us in the Directory Include us, but exclude the following information listed below DCC 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 permission No, I do not give my permission I 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 considerationsinclude 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 only Registration Fee and 1/2 Annual Tuition Registration Fee and Full Annual Tuition Pay by check Please 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 only = $50; Registration Fee plus 1/2 Tuition = $175; Registration Fee plus Full Tuition = $300. 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.