Menu Close
  • Home
  • Jubilate-Deo-Workshop-Registration
    •
Student One Name
Name of your first student Registering
Please enter your student one age here.
Please enter the grade your student will be enrolling this fall.
Do you have additional students to register?
Student Two Name
Name of your second student Registering
Please enter your students age here.
Please enter the grade your student will be enrolling this fall.
Student Three Name
Name of your third student Registering
Please enter your students age here.
Please enter the grade your student will be enrolling this fall.
Student Four Name
Name of your fourth student Registering
Please enter your students age here.
Please enter the grade your student will be enrolling this fall.
Student Five Name
Name of your fifth student Registering
Please enter your students age here.
Please enter the grade your student will be enrolling this fall.
Parent or Guardian Name
Address
Type of Phone?
Emergency Contact Name
Please enter any medical, food allergies, about each student here.
Jubilate Deo Lutheran Music Workshop Liability Waiver Agreement
“Participants and their parents hereby agree to indemnify and hold harmless St. Paul’s Music Conservatory & St. Paul’s Evangelical Lutheran Church of Council Bluffs, IA, its officers, board members, employees, and volunteers, from and defend against all claims brought or actions filed, for any and all claims, suits, actions debts, damages, costs, charges, and expenses including court costs, and attorney’s fees, and against all liability, losses, and damages of any nature whatsoever, including but not limited to property damage and personal injury, including death resulting at any time there from, arising from any alleged acts of negligence, either active or passive, of the participant or any person acting on his/her/its behalf arising from the activities which are the subject matter of this contract.”
Photograph Permission
I hereby give permission for photographs taken during the Jubilate Deo Lutheran Music Workshop to be used by St. Paul’s Music Conservatory of the above student(s) to be used for promotional purposes, including fliers, websites, Facebook, Instagram (Social Media Pages), news features, etc.