Parent/Guardian Info

First Name *

Last Name *

Email *

Please use a valid email address as this is our primary way to contact you regarding this application.

Phone *

Address *

City *

State *

Postal code *

Child's Info

Program

Select which program you are registering your child for.

Child's First Name *

Child's Last Name *

Child's Date of Birth *

School & Current Grade *

Child's Ethnicity *

This information is required for us to fulfill or grant report responsibilities only. This ensures we are able to continue providing tuition-free programs for the Huntsivlle community.

Any Allergies We Should Be Aware Of

Other Info

Emergency Contact Name *

Emergency Contact Number *

How did you hear about us? *

Payment

Payment *

$ 25

You must select the payment amount above.

I understand that the Huntsville Drumline Percussion and Performing Arts Center/HCDL, takes photographic, digital or video images of programs/classes/event participants for advertising purposes. I hereby agree to allow Huntsville Drumline Percussion and Performing Arts Center/HCDL to use those images for that purpose without expectation of privacy or remuneration. By providing my phone number and email, I agree to receive text messages and emails from HCDL.