ACG Youth Ensembles Registration Form Student Name* First Last Student Email Student Grade Parent Name* First Last Parent Email* Parent Phone Number*Select an Ensemble*ACG Youth CamerataACG Youth OrchestraTuition Options*Tuition for the ACG Youth Camerata 2022-2023 session will be $300. Scholarships and payment plans are available for those who need it. Pay full tuition now - $300 Please inform me about scholarship opportunities or payment plans Tuition Options*Tuition for the ACG Youth Orchestra 2022-2023 session will be $500. Scholarships and payment plans are available for those who need it. Pay full tuition now - $500 Please inform me about scholarship opportunities or payment plans Would You Like to Donate to Support Another Member Yes No Donation OptionsSupport One Additional MemberSupport Two Additional MembersSupport Three Additional MembersDonations OptionsSupport One Additional MemberSupport Two Additional MembersSupport Three Additional MembersTotal $0.00 Credit Card* American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card # Month010203040506070809101112 Year20222023202420252026202720282029203020312032203320342035203620372038203920402041 Expiration Date Code Cardholder Name Billing Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Media Release and Member Agreement* By checking this box, as the parent or guardian of the student listed above, I hereby give Austin Classical Guitar (ACG) and its employees, representatives, and authorized media organizations permission to print, photograph, and record my child for use in audio, video, film, or any other electronic, digital, and printed media. I am aware that I will not receive monetary compensation for my child’s participation, and I release and relieve ACG, its Board of Trustees, employees, and other representatives from any liabilities, known or unknown, arising out of the use of this material. By checking this box, I also indicate that I, and my child, read and agree to the policies set forth in the ACG Youth Ensembles Member Policies and Agreements Form provided to you by your child’s director at the beginning of each session. ACG Newsletter Please sign me up to receive ACG's e-newsletter. Comments, questions, suggestions?NameThis field is for validation purposes and should be left unchanged. Δ
