CYO

member information form



Member Information Form

The personal information collected on this form is collected under the authority of the Alberta Freedom of Information and Protection of Privacy Act Section 33(c) and is protected by that act. This information will be used for CYO program purposes, and will not be shared with any third party. Red text indicates required fields. Please fill these out accurately.

CYO Member’s Information:
First Name:
Last Name:
Birth Date:
Street Address:
Apt:
City:
Postal Code:
Home Phone:  
Cell Phone:  
E-mail:
Instrument Played:
Emergency Contact:
Relationship to Member:
Contact Phone:  Area Code:


Father’s Information:
First Name:
Last Name:
Street Address:
City:
Postal Code:
Home Phone:  Area Code:
Note: the following three lines are required information for emergency purposes. If your father does not have a cell or work phone number, or email address, please enter "NA" in those fields."
Cell Phone:  Area Code:
Work Phone:  Area Code:   (emergencies only)
Father’s Email:


Mother’s Information:
First Name:
Last Name:
Street Address:
City:
Postal Code:
Home Phone:  Area Code:
Note: the following three lines are required information for emergency purposes. If your mother does not have a cell or work phone number, or email address, please enter "NA" in those fields."
Cell Phone:  Area Code:
Work Phone:  Area Code:   (emergencies only)
Mother’s Email:


Music Deposit Cheques:

Music Deposit cheques will be kept securely in the CYO office. Cheques will not be deposited without just cause. To save postal charges, it is our preference to shred cheques not cashed or have you pick them up at the Conservatory office in June.

Please indicate your preference:

    



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