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Momentum Choir Registration 2023-2024 - Our 16th season!!!!
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Name
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Email address - you may enter more than one email address - ie. Family members, staff or support.
Your answer
2nd email address (If necessary)
Your answer
3rd email address (if necessary)
Your answer
What is your Street address? (Number and Street)
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What is your City/Town?
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What Province do you live in?
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What is your Postal Code?
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If you have a primary staff or support, what is their name and telephone number?
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Who is your emergency contact?
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What is your emergency contact's phone number?
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What is your birthdate?
MM
/
DD
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YYYY
What is your telephone number?
Your answer
Which Momentum Choir are you signing up for?
Momentum Niagara (St. Catharines) Tuesdays from 3:30-4:30
Momentum Hamilton - Mondays from 3:30-4:30
Momentum Without Borders (our virtual choir) Thursdays, online from 3:30-4:30
Momentum Choir would like to post videos and photos of the choir and choir members on our social media pages, our website and the internet. Do you give Momentum Choir consent to do this?
Yes
No
Other:
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Are you connect with an agency, group or association?
Example - Community Living, Christian Horizons, Autism Ontario...
If so, please explain.
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Is there any other information you'd like to share with us?
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