REGISTRATION FORM

To register now for SING! Adult,  please fill out the form below. Please note, fields with an asterisk (*) before them are required.

Section 1 of 4: Participant Information
Name *
Name
Address *
Address
Cell phone *
Cell phone
Home phone
Home phone
Voice Part *
Date of birth *
Date of birth
Gender *
How did you learn about the program? *
T-shirt size *
Section 2 of 4: Emergency contact information
Emergency contact name *
Emergency contact name
Emergency contact phone number *
Emergency contact phone number
Emergency contact alternate phone number
Emergency contact alternate phone number
Emergency contact street address *
Emergency contact street address
Section 3 of 4: Musical Information
Private teacher name
Private teacher name
Section 4 of 4: Program Selection and Payment
Select one package *
Package A (overnight) includes housing, all meals, and evening offerings. Package B (days & evenings) includes all meals and evening offerings. Departure is at 9:00pm. Package C (days only) includes lunch. Departure is at 5:45pm.
Add-On Classes *
Early Registration A Discount
To qualify you must register and pay in full by April 1
Early Registration B Discount
To qualify you must register and pay in full by May 1
Add the price for your package selection and your add-on classes, then subtract the appropriate registration discount (if any).
$
Method of payment *
Terms and Conditions for Enrollment
Photo/Video Consent *
Do you give permission for Sing This Summer, Inc. to use your child's photograph, video and audio recordings, likeness, and comments in publications, web pages and other promotional materials produced, used by and representing Sing This Summer, Inc. for the purpose of promoting the program? The circulation of the materials could be worldwide and there will be no compensation for this use.
Please confirm the following *
I understand that upon receipt of my registration form and fee, no refunds or deductions for the cost of the program will be made for any reason including cancellation, late arrival, early departure, sickness or expulsion for disciplinary reasons as explained by the rules distributed upon arrival by Sing This Summer, Inc., Amherst College, federal, state and local law. The student is registered upon receipt of completed registration packet and fee. The balance must be paid by June 1, 2017. Applications are accepted on a first-come, first-served basis. I understand all SING! and Strings@Amherst participants are required to comply with camp and college rules and regulations and any federal, state, and local law. Violations or misconduct will result in immediate dismissal from camp without refund. The program is inspected and certified by the Massachusetts State Department of Health. Sing This Summer, Inc. does not discriminate on the basis of sex, race, color, national or ethnic origin, religion or physical handicap. By checking this box I confirm that I have read and agree to the above "Terms and Conditions for Enrollment". I understand that this form is being submitted electronically and that my typed name below shall constitute my signature on this registration form. My signature and submission of this form indicate that I agree to the "Terms and Conditions for Enrollment".
Date of submission *
Date of submission