Youth Chime Choir Permission Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

For 3rd through 8th Grade
Practices are on Wednesdays beginning September 6
2:45-3:15pm or 4:15-4:45pm

Child's Last Name *

Child's First Name *

Parent's Full Name *

Parent email *

Parent Phone Number *

Address

Grade Level of Child *

Emergency Contact Person *

Emergency Contact Phone Number *

Insurance Company

Policy Number

Allergies or health concerns *

Which chimes session is your child planning to attend? *

2:45-3:15pm

4:15-4:45pm

Please list who is authorized to pick up your child. *

My child is permitted to walk home. (please check yes or no) *

Yes

Questions?

If you have any questions, please feel free to reach out to Mr. Phil Caffee at pcaffee@scaoaklawn.org or 708-425-3110 or 708-476-5374

Due to parental changes in schedules, please contact Mr. Caffee before practice begins to alert him of changes.

Remind directions for text alerts: text @bellchime1 to 81010

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of St. Catherine of Alexandria School. Report Abuse