Registration form Please complete the form below to register for the Junior or Senior Choir. Returning choristers, please complete all applicable fields. Which choir are you applying for?Choir*New Chorister Junior Choir: Year 3 - 6New Chorister Senior Choir: Year 7 to age 30 yearsReturning Chorister JuniorReturning Chorister SeniorWaratah Ensemble - Alumni onlyChorister InformationChorister’s First Name* Chorister’s Last Name Address Street Address City State / Province / Region ZIP / Postal Code Chorister’s mobile phoneChorister’s e-mail Date of birth DD slash MM slash YYYY Sister's name in choir (if applicable) School Attending Year at school Primary emergency contactFirst Name Last Name Relationship 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 Name Last Name Relationship 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.FileMax. file size: 300 MB.Legal 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 ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month010203040506070809101112 Year20232024202520262027202820292030203120322033203420352036203720382039204020412042 Security Code Cardholder Name CAPTCHA
