2022 SPRING Chorus Application gbcchorus@gmail.com greaterburlingtonchildrenschorus.org

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For singers in 2nd-8th grade. *1st graders admitted pending a simple audition and/or teacher recommendation. Hosted at Rice High School, Burlington Vermont.

Email *

Spring programming is MONDAYS, 3:45-5:15pm, BEGINNING January 24th, 2022. FINAL CONCERT May 14, 2022. HOSTED @ RICE HIGH SCHOOL. Cost is $295. *

I plan on paying the full $295 tuition. By check to: GBCC, 140 Summit St. Burlington VT 05401 or thru VENMO for Business @gbcchorus *Add 3% ($9) to payments made through Venmo. Payment options will also be sent via email.

I plan on applying for financial assistance. GBCC will send the application via email.

Other : Parent is the Board Member of GBCC

Student Full Name: Siya Dahal *

Student Date of Birth: 08/01/2013 *

YYYY

I am registering my child for grades 2-8 Chorus. MONDAYS 3:45-5:15. Students may arrive early for a quiet supervised time, if needed. My child is in grade: 3rd *

*1st graders admitted pending a simple audition and/or teacher recommendation.

Other:

Required

Name of school student attends: Mater Christi School *

Parent/Guardian Full Name: Bidur Dahal *

Address: 36 Gilman Circle, Unit 4, Colchester, VT 05446 *

Phone: 802-399-1573 *

Emergency Contact: Name, Relationship to student, and Phone #: Radika Dahal, Mother, 802-777-6273 *

Student's Pediatrician and Phone #: Dr. Stanley Weinberger, UHC Peds; Ph# 802-847-4696 *

I will not hold GBCC, or it's partners or sponsors, responsible whatsoever for any harm which may come to my child as a result of participation in GBCC programming. *

I agree, and with this answer provide my legal assent to the above statement.

I grant permission for my child's image to be used in promotional materials: *

Yes

Other: Please provide details in space below.

Please share any additional information about your child that you would like us to know:

I would be interested in potential future programming for my Pre-School - 1st grade child.

Pre-School

Pre-Kindergarten

Kindergarten

1st Grade

Please let us know how you heard about GBCC. Thank you! Christa and Board Meeting. *

Financial support from friends like you, and businesses like yours, make our programming accessible to all. Tax deductible donations are accepted on our website, and via check to GBCC, 140 Summit St. Burlington VT 05401. More information at the bottom of our website www.greaterburlingtonchildrenschorus.org, or by contacting us at gbcchorus@gmail.org. Thank you for supporting GBCC and partnering with us in building something beautiful for our community!

After submitting this form, we will be in touch with further chorus details and payment information or a financial assistance form. Registrations are not complete until payment is received. Thank you for registering your child with GBCC!

A copy of your responses will be emailed to the address you provided.

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