Youth Guild Membership Application

Parent/Guardian Name*
First Last
Email*
Enter Email Confirm Email
Phone*
Address*
Street Address Address Line 2 City State ZIP Code
Did your family have a Youth Guild membership last year?
- Yes
- No
How did you hear about the Youth Guild?*
Were you referred by someone?
- Yes
- No
If yes, who?
Are you interested in purchasing Youth Guild Vouchers?*
- Yes
- No
For more information on the Youth Guild Voucher program, please visit the previous page.
If you answered yes to purchasing vouchers, a patron services representative will attempt to get in touch with you to complete payment. Please provide a phone number and general time of day in which they can reach out to you. (Example: (801) 123-4567, Evenings after 5 pm)
Child 1 Information
Child 1 Name*
First Last
Child 1 Age*
Child 1 Date of Birth*
MM slash DD slash YYYY
Child 1 School*
Child 1 School District*
Child 1 Instrument (if applicable)
Child 1 Music Teacher Name (if applicable)
First Last
Child 1 Music Teacher Email (if applicable)
Child 2 Information
Child 2 Name
First Last
Child 2 Age
Child 2 Date of Birth
MM slash DD slash YYYY
Child 2 School
Child 2 School District
Child 2 Instrument (if applicable)
Child 2 Music Teacher Name (if applicable)
First Last
Child 2 Music Teacher Email (if applicable)
Child 3 Information
Child 3 Name
First Last
Child 3 Age
Child 3 Date of Birth
MM slash DD slash YYYY
Child 3 School
Child 3 School District
Child 3 Instrument (if applicable)
Child 3 Music Teacher Name (if applicable)
First Last
Child 3 Music Teacher Email (if applicable)
Child 4 Information
Child 4 Name
First Last
Child 4 Age
Child 4 Date of Birth
MM slash DD slash YYYY
Child 4 School
Child 4 School District
Child 4 Instrument (if applicable)
Child 4 Music Teacher Name (if applicable)
First Last
Child 4 Music Teacher Email (if applicable)
Additional Children's Information. Comments or questions?

Youth Guild Membership Application

Child 1 Information

Child 2 Information

Child 3 Information

Child 4 Information