Program Registration Δ Participants Name(Required) First Last Date of Birth(Required) Email(Required) Phone(Required)Gender She/Her He/Him They/Them Prefer Not to Say Prefer to Self-Describe: Self DescriptionAddress(Required) Street Address City State / Province / Region Program InformationProgramChoose a ProgramClassical IntensivePiano IntensiveString PlayhouseIsland JazzArea(s) of Focus (Instrument(s), Performance Experience, Vocal Range, ETC)Current Level + Years ExperienceInterest in Accommodations?(Required) Yes No Undecided Interest in Meals?(Required) Yes No Undecided Shirt Size - One free T-shirt included. Additional apparel available for purchase.(Required)SMLXL2XL3XL4XL5XLParental InformationParent/Guardian Name(s)(Required)Guardian(s) Phone Number(Required)Guardian(s) Email Addess(Required) Emergency + Medical Information Emergency Health Card Number(Required)Emergency Contact(Required)Emergency Phone Number(Required)Emergency Email(Required) Relationship to Student *(Required)Allergies (if any)Present Medication and/or Treatment *(Required)Name of Participants Physician:Physician's Contact:Any Relevant Medical Information (operations, injuries, or hospitalizations)(Required)Special Food Requirements(Required)List any areas of concernPermissions For Participants under 18 only Does the participant have permission to leave CYMC facilities with anyone (For Participants under 18 only) * Yes No If Yes, Please Provide Names and numbersI agree to the Terms and Conditions(Required) Yes I agree to the Code of Conduct(Required) Yes I will be applying for a Bursary Yes How did you find out about CYMC?$90 Non Refundable Deposit Price: Credit Card(Required)
