Fall 2019 Care Partner Registration

                                             

Contact Information

Since you will be a care partner for the Sentimental Journey Singers (SJS), please type in the name of the singer who you will be partnering with this semester. 

SJS Singer Name*
Country*
Email*
Confirm Email*
Phone*
Mobile Phone*

(Please enter your phone numbers in the following format xxx-xxx-xxxx)

 

Locations

Please choose the following location.  Type the number "1" in the location chosen and your total will calculate.

Quantity
Price
Total
Sentimental Journey Singers
X
$
25.00=
$
0
If you are a new singer, how did you hear about Encore?
Voice Part*
  • Alto
  • Bass
  • Soprano
  • Tenor
Birthdate

(Please enter your birthdate in the following format mm/dd/yyyy)

Emergency Contact Name*
Emergency Contact Phone #*

(Please enter your credit card number below without dashes)

By registering for this program, I grant to Encore Creativity Corporation (Encore), its representatives and employees the right to take photographs of me or create video content that includes me in connection with Encore concerts and other program activities. I authorize Encore to copyright, use and publish the same in print and/or electronically. I agree that Encore may use such photographs of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content.

Payment Information

Amount*
$
Name on Card*
Card Number*
Additional Comments

Security Code

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