Young Emcees Form — Art Porter Music Education

Art Porter Young Emcees Online Application

Student Name

First Name

Last Name

Birthday

MM

DD

YYYY

Grade

School

Shirt Size

Food Allergies

Yes

No

Favorite subject in school:

What do you do for fun:

Parent Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Email

Date

MM

DD

YYYY

Parent's digital signature:

Art Porter Music Education has my permission to use my child’s name or image for informational and promotional purposes only.

We work with a limited number of youth for performances at our fundraisers in February-For the Love of Art; April-Jazz in the Park; August- A Work of Art and September-Jazz in the Park.