Supplementals Membership Plan (Pay In 3 Months) Terms: 3 payments of $59 / Month First Name:* First Name Required Last Name:* Last Name Required Address Line 1:* Address Line 1 is Required Address Line 2: Address Line 2 is not valid City:* City is Required Country:* Country is Required -- Select Country -- United States (US) Afghanistan Åland Islands Albania Algeria Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belau Belize Benin Bermuda Bhutan Bolivia Bonaire, Saint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo (Brazzaville) Congo (Kinshasa) Cook Islands Costa Rica Croatia Cuba CuraÇao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Republic of Ireland Isle of Man Israel Italy Ivory Coast Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao S.A.R., China Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Norway Oman Pakistan Palestinian Territory Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Barthélemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint Martin (Dutch part) Saint Pierre and Miquelon Saint Vincent and the Grenadines San Marino São Tomé and Príncipe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia/Sandwich Islands South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom (UK) Uruguay Uzbekistan Vanuatu Vatican Venezuela Vietnam Wallis and Futuna Western Sahara Western Samoa Yemen Zambia Zimbabwe State/Province:* State/Province is Required Zip/Postal Code:* Zip/Postal Code is Required What first and last name would you like on your name tag?: What first and last name would you like on your name tag? is not valid Phone: Phone is not valid Email: Email is not valid How long have you been singing with Voices Rock?: How long have you been singing with Voices Rock? is not valid How did you hear about Voices Rock?: How did you hear about Voices Rock? is not valid Who can we thank for the referral?: Who can we thank for the referral? is not valid What voice part do you sing?: What voice part do you sing? is not valid Do you read music?: Do you read music? is not valid The pronouns I use are:: The pronouns I use are: is not valid When is your birthday? (optional): When is your birthday? (optional) is not valid I consent to allowing Voices Rock to use images of me taken during sessions, concerts, and public singing events that maybe used in Voice’s Rock marketing material (website, social media, printed material, etc.): I consent to allowing Voices Rock to use images of me taken during sessions, concerts, and public singing events that maybe used in Voice’s Rock marketing material (website, social media, printed material, etc.) is not valid I agree to receive text messages for last minute rehearsal changes: I agree to receive text messages for last minute rehearsal changes is not valid I am fully vaccinated and will provide proof.: I am fully vaccinated and will provide proof. is not valid Bio: Tell us a little about yourself! (family, career, hobbies, ect): Bio: Tell us a little about yourself! (family, career, hobbies, ect) is not valid Age Group: Age Group is not valid What name do you want on your name tag (first, last)?: What name do you want on your name tag (first, last)? is not valid Choose a Choir Location: Choose a Choir Location is not valid Child's Name: Child's Name is not valid How would your child like their VR2 name tag to read?: How would your child like their VR2 name tag to read? is not valid Name of School: Name of School is not valid Grade: Grade is not valid Allergies: Allergies is not valid If Yes, Please list known allergies.: If Yes, Please list known allergies. is not valid Social/emotional needs we should be aware of: Social/emotional needs we should be aware of is not valid T-shirt Size: T-shirt Size is not valid Does your child have previous music/singing experience?: Does your child have previous music/singing experience? is not valid Do you consent to allowing Voices Rock to use images of your child taken during sessions, concerts, and public singing events that maybe used in Voice’s Rock marketing material (website, social media, printed material, etc.)?: Do you consent to allowing Voices Rock to use images of your child taken during sessions, concerts, and public singing events that maybe used in Voice’s Rock marketing material (website, social media, printed material, etc.)? is not valid Do you agree to receive text messages for last minute rehearsal changes?: Do you agree to receive text messages for last minute rehearsal changes? is not valid Is your child fully vaccinated and will you provide proof?: Is your child fully vaccinated and will you provide proof? is not valid Vaccine last booster date: Vaccine last booster date is not valid First and last names of people allowed to pick up student: First and last names of people allowed to pick up student is not valid Emergency Contact Name: Emergency Contact Name is not valid Emergency Contact Email: Emergency Contact Email is not valid Emergency Contact Phone: Emergency Contact Phone is not valid Relationship to Child: Relationship to Child is not valid Any other information about your student that you feel is important to share?: Any other information about your student that you feel is important to share? is not valid Please upload a profile photo of your child: Please upload a profile photo of your child is not valid Please upload a profile photo: Please upload a profile photo is not valid Parent Name: Parent Name is not valid Username:* Invalid Username Email:* Invalid Email Password:* Invalid Password Password Confirmation:* Password Confirmation Doesn't Match Password Strength Have a coupon? Coupon Code: Invalid Coupon Stripe Pay with your Credit Card via Stripe Checkout Javascript is disabled in your browser. You will not be able to complete your purchase until you either enable JavaScript in your browser, or switch to a browser that supports it. No val Please fix the errors above