Application form Please complete the form below to apply for a position in the Junior or Senior Choir. Returning choristers, please complete all applicable fields. Which choir are you applying for?Choir*Junior Choir: Year 3 - 6Senior Choir: Year 7 to age 30 yearsWaratah Ensemble: Alumni onlyReturning ChoristerChorister InformationChorister’s First Name*Chorister’s Last NameAddress Street Address City State / Province / Region ZIP / Postal Code Chorister’s mobile phoneChorister’s e-mail Date of birth Date Format: MM slash DD slash YYYY Sister's name in choir (if applicable)School AttendingYear at schoolPrimary emergency contactFirst NameLast NameRelationship to chorister:RelationshipMotherFatherGuardianPartnerOtherAddress (if different to above) Street Address City State / Province / Region ZIP / Postal Code Mobile phoneHome phone (optional)Work phone (optional)E-mail Would you like to have your name included in the parent helper list? (camps, music, uniform, fundraising, event assistance, other)IncludeYesNoSecondary emergency contactFirst NameLast NameRelationship to chorister:RelationshipMotherFatherGuardianPartnerOtherAddress (if different to above) Street Address City State / Province / Region ZIP / Postal Code Mobile phoneHome phone (optional)Work phone (optional)E-mail Health and medical informationIt is a requirement that parents provide details of any predetermined illnesses, including mental and physical health considerations. WGC must be immediately notified if any medical information changes during your daughter’s enrolment.Does your daughter have any of the following listed conditions? (Tick all that apply) None Allergy Anaphylaxis Anxiety Asthma Asperger’s/Autism Spectrum Disorder Diabetes Epilepsy/Seizures Hearing loss Mobility (Arthritis, Scoliosis, Cerebral Palsy) Physical disability (wheelchair, walking frame) Other (e.g. ADHD, depression, dyslexia, skin condition, dizziness/fainting, bladder/bowel disorder, migraines, heart condition) Vision impairment If yes to any of the above, please indicate severity and summarise symptom and treatment details below.Allergy text fieldIs a Medical Action Plan required? Some health matters require a Medical Action Plan (MAP) in case of emergency. If yes, please attach the chorister’s MAP provided by a doctor.FileLegal details Is your child subject to a court order that affects who can collect her from choir rehearsals and events? If yes, please provide further details below.Legal text field PaymentTotal $ 0.00 Credit Card DetailsPlease note: We do not store your card details at any time. American ExpressDiscoverMasterCardVisa Card Number Expiration Date Month010203040506070809101112 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Security Code Cardholder Name CAPTCHA This iframe contains the logic required to handle Ajax powered Gravity Forms.
