Children&#039;s Christmas Choir

Registration Form

Parent/Guardian's First and Last Name REQUIRED Please fill out this field. Please enter valid data.

Email REQUIRED Please fill out this field. Please enter an email address.

Primary Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Receive text messages? REQUIRED Yes No Please fill out this field.

Is the primary parent/guardian a member of St. John Paul II Catholic Church/ REQUIRED Yes No, but we regularly attend JPII for Mass. No, but we are a registered school family of JPII School. No, but we regularly attend another church (any denomination) No, but we are interested in information about membership. No, we do not regularly participate in a church home. Please fill out this field.

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Student #1 First and Last Name REQUIRED Please fill out this field. Please enter valid data.

Student #1 Current Grade REQUIRED 2 3 4 5 6 Please fill out this field.

Where does student #1 attend school (including homeschooling)? REQUIRED Please fill out this field. Please enter valid data.

Important medical/emotional/other information that is important for us to know in order for this student to have a positive, supportive experience.

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Student #2 First and Last Name Please enter valid data.

Student #2 Current Grade 2 3 4 5 6

Where does student #2 attend school (including homeschooling)? Please enter valid data.

Important medical/emotional/other information that is important for us to know in order for Student #2 to have a positive, supportive experience.

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Student #3 First and Last Name Please enter valid data.

Student #3 Current Grade 2 3 4 5 6

Where does student #3 attend school (including homeschooling)? Please enter valid data.

Important medical/emotional/other information that is important for us to know in order for Student #3 to have a positive, supportive experience.

Electronic Signature REQUIRED Please fill out this field. Please enter valid data.

Signature Date REQUIRED Please fill out this field. Please enter valid data.

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Medical Authorization

In the event of an emergency in which I cannot be reached, I authorize the Church’s staff or volunteers to seek emergency medical treatment for my child. I accept financial responsibility for any medical care deemed necessary.

Electronic Signature (type your name) REQUIRED Please fill out this field. Please enter valid data.

Emergency Contact (if different from above) (First and Last Name): REQUIRED Please fill out this field. Please enter valid data.

Emergency Contact's Phone Number REQUIRED Please fill out this field. Please enter valid data.

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Liability Release (Indiana)

I, the undersigned parent or legal guardian of the above-named child, give permission for my child/children to participate in the Children’s Choir rehearsals held by St. John Paul II Catholic Church ("The Church").

I understand that participation in choir activities involves normal childhood interactions and light physical activity. I acknowledge that the Church takes reasonable steps to provide a safe environment but cannot eliminate all risks associated with group activities.

To the fullest extent permitted by Indiana law, I hereby release, waive, and discharge the Church, its pastors, employees, volunteers, representatives, and agents (“Released Parties”) from any and all liability, claims, damages, demands, or causes of action arising from my child’s participation in choir rehearsals, except for injuries or damages resulting from the Released Parties’ gross negligence or willful misconduct, which cannot be waived under Indiana law.

I further agree to indemnify and hold harmless the Released Parties from any claim or expense arising out of my child’s participation, except to the extent caused by gross negligence or willful misconduct.

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Media Release (Check One)

Media Release REQUIRED Yes, I give permission for my child’s/children's image, voice, or likeness to be used in church communications, including photos or video recordings of choir activities. No, I do not give permission. Please fill out this field.

St. John Paul II Parish

St. Paul & St. Joe Hill Campuses
216 Scheller Ave & 2605 W. St. Joe Rd, Sellersburg, IN

Children's Christmas Choir

Mandatory For All Participants:
Dress Rehearsal: Monday, Dec. 22nd, 5:30-7:30 p.m.

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Medical Authorization

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Liability Release (Indiana)

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Media Release (Check One)

Children's Christmas Choir

Mandatory For All Participants:Dress Rehearsal: Monday, Dec. 22nd, 5:30-7:30 p.m.

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Medical Authorization

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Liability Release (Indiana)

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Media Release (Check One)

Mandatory For All Participants:
Dress Rehearsal: Monday, Dec. 22nd, 5:30-7:30 p.m.