Children’s and Youth Choirs

Child's Name *

First

Last

Child's Date of Birth *

Child's Grade *

Child's School

Which Choir? *

Cherub Choir (Preschool - K) Wednesdays 3:00-3:25 PM
Carol Choir (Grades 1 - 3) Wednesdays 3:40-4:20 PM
St. Cecilia Choir (Grades 4 - 8) Wednesdays 4:30-5:30 PM

Brick Church Members? *

Yes
No

Does the Child have allergies? *

Yes
No

Allergies *

Please list allergies here and describe allergy plan (if plan is necessary).

Does the child play an instrument?

Yes
No

Instrument

What instrument and for how long?

Parent and/or Guardian's Names *

Parent's Email address *

Mailing Address

Phone number *

Caretaker's name and mobile number

Release *

Grant Permission
Do Not Grant Permission

I hereby grant the Brick Presbyterian Church in the City of New York the right to use photographs and/or video of me and/or the child or children listed in this application for church publications, electronic reproductions (website and social media) and/or promotional materials. Further I attest that I am the parent or legal guardian of the child or children listed above. I also acknowledge that participation is completely voluntary. The Brick Presbyterian Church will not identify individuals in external media publications. Children's names and contact information will not be listed. According to our Safe Sanctuary Policy, photos of children will not be used in external publications without parental consent. Please refer to our Brick Presbyterian Church Web Policy for publication policies. I hereby release the Brick Presbyterian Church in the city of New York from all claims and liability relating to said photographs, videos or quotes.