Member Info Form

 

Contact Info
Name *
Name
Cell Phone *
Cell Phone
Home Address *
Home Address
Ensemble Info
Birthdate *
Birthdate
Ageout *
Is this your last season of eligibility?
Seasons *
Which seasons have you been a part of Rhythm X?
Emergency Contact Info
Parent 1 *
Parent 1
Parent 1 Phone *
Parent 1 Phone
Parent 2
Parent 2
Parent 2 Phone
Parent 2 Phone
Other Emergency Contact *
Other Emergency Contact
Someone other than your parents we can call in case of emergency.
How are you related to your emergency contact?
Emergency Contact Phone *
Emergency Contact Phone
Bio Info
Name *
Name