St. Rose of Lima

A Catholic Church located in Gaithersburg, MD

All Are Welcome • Todos Somos Bienvenidos

Pray ... Grow ... Serve
Orar ... Crecer ... Servir

Music Ministry for Youth Registration Form

- Parish Life

Registration for 2017-2018 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 Please fill out this field.
  
  Singer Voice REQUIRED Please fill out this field.
  
  Instruments that you play REQUIRED Please fill out this field. Please enter valid data.
  
  Home Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Student Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
- Student Email Address REQUIRED Please fill out this field. Please enter an email address.
- How do you prefer to be contacted? Text Message to student cell phone Email to parents and student
- School that you attend REQUIRED Please fill out this field. Please enter valid data.
- Grade for the 2017-2018 year REQUIRED Please fill out this field.
- Parent 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.
  
  Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Home Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
- Special Concerns? Allergies? Please be specific. REQUIRED Please fill out this field. 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 Please fill out this field.
Submit
Contact us:
- Jeannie Downey-Vanover, PhD
  
  Director of Music Ministry for Youth
  
  240-506-0258
  jdowneyvanovergmail.com