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Bridges Choir Contact Form 2021-2022
If you have any questions about choir before filling out this form, please contact Mr. Brewer by email at
jeremy.brewer@husd.org
, or by voicemail at (480)279-9734.
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* Indicates required question
Student Last Name
*
Last Name
Your answer
Student First Name
*
First Name
Your answer
Grade Level
*
4th grade
5th grade
6th grade
T-Shirt Size
*
Y-S
Y-M
Y-L
Y-XL
A-S
A-M
A-L
A-XL
A-XXL
Option 10
Birthday
*
MM
/
DD
/
YYYY
Student Email
Type "None" if none
Your answer
Parent/Guardian Name 1
*
First Last
Your answer
Parent/Guardian Name 2
First Last
Your answer
Parent Contact Email 1
*
Your answer
Parent Contact Email 2
Your answer
Phone 1
*
Choose
Home
Cell
Work
Phone 1
*
(XXX) XXX-XXXX
Your answer
Phone 2
Choose
Home
Cell
Work
Phone 2
(XXX) XXX-XXXX
Your answer
Phone 3
Choose
Home
Cell
Work
Phone 3
(XXX) XXX-XXXX
Your answer
Does your child have permission to be photographed or videotaped for educational or promotional purposes?
*
Yes
No
Anything else that is important for me to know to help your child be successful and safe (e.g. specific health or emotional issues, custody issues, etc.)
Your answer
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