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St. Rose of Lima
A Catholic Church located in Gaithersburg, MD
All Are Welcome • Todos Somos Bienvenidos
Pray ... Grow ... Serve
Orar ... Crecer ... Servir
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Registration for 2018-2019 Music Ministry for Youth
The maximum number of form submissions has been reached. This form is currently not available.
Student Information
First Name
REQUIRED
Please fill out this field.
Please enter valid data.
Last Name
REQUIRED
Please fill out this field.
Please enter valid data.
Choir
REQUIRED
(Select One)
Celebration Choir (CC)
Children Love Christ Choir (CLC)
Teens Love Christ Choir (TLC)
Please fill out this field.
Singer Voice
REQUIRED
(Select One)
Soprano
Alto
Tenor
Bass
Please fill out this field.
Instruments that you play
REQUIRED
Please fill out this field.
Please enter valid data.
Home Address
REQUIRED
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Please enter valid data.
City
REQUIRED
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Please enter valid data.
State
REQUIRED
AK
AL
AR
AS
AZ
CA
CO
CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MH
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
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Zip
REQUIRED
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Please enter a zip code.
Student Cell Phone Number
Please enter a phone number.
Student Email Address
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How do you prefer to be contacted?
Text Message to student cell phone
Email to parents and student
School that you attend
REQUIRED
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Please enter valid data.
Grade for the 2018-2019 year
REQUIRED
(Select One)
Kindergarten
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12
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Parent Information
First Name
REQUIRED
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Last Name
REQUIRED
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Cell Phone Number
REQUIRED
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Please enter a phone number.
Home Phone Number
REQUIRED
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Please enter a phone number.
Email
REQUIRED
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Please enter an email address.
Special Concerns? Allergies? Please be specific.
REQUIRED
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Please enter valid data.
Our Music Ministry website will include occasional photos. Do you give permission for your child's photo to appear there?
REQUIRED
(Select One)
YES
NO
Please fill out this field.
Submit
Contact us:
Jeannie Downey-Vanover, PhD
Director of Music Ministry for Youth
240-506-0258
jdowneyvanover
gmail.com