Young Adult Choir — Music Therapy

Integrated Young Adult Choir is BACK!

We are BEYOND thrilled to be able to bring back the Young Adult Choir For a full weekly choir season!!

Starting Monday, January 29th at 4:30-5:30pm.

As usual, choir sessions will be focused on supporting communication skills and social interaction opportunities in a fun, supportive, and accessible format. Young adults of ALL ABILITIES are welcome and new participants are invited to try the group before committing to the fall semester. Ages 16 and up are included, and musical skill or previous experience is NOT required.

Groups will be offer in-person at the University Center for the Arts in Fort Collins, CO and online via Zoom for participants who are unable to attend in person or are outside of the Northern Colorado area.

Please fill out the information below... (If you or your young person have registered in previous seasons, please feel free to provide only the required information and any necessary updates.) Current ITNC individual clients may be able to use waiver funds for limited spots, select this option, and ITNC will reach out to confirm availability of this option.

This participant will be joining the group

please select one

Participant Name

First Name

Last Name

Age

Parent/Guardian/Caregiver Name

Primary Contact Phone Number

Please use this box for emergency contact number

Primary Contact Email Address

ITNC values your privacy and will NEVER share your contact information outside of ITNC and this program.

How would you like to fund registration?

Please select one option

Allergies/Safety Precautions

Current Therapies/Activities

Does participant have speech/communication difficulties? Please describe.

Does participant have social interaction difficulties? Please describe.

Musical Preferences and Experience:

Please share any preferred/familiar musical genres, artists, soundtracks, as well as any relevant experience. We do our best to incorporate preferences into the selections used in choir.

Will an aide be participating with the young adult?

Yes

If yes, name:

Is there anything else you would like us to be aware of?

I provide consent for my/my child's photograph or videography of participation in this program to be used to promote the service in print and/or media.

I do consent

I do NOT consent

Would you like more information about ITNC and/or music therapy?

If you've previously selected a communication preference, that preference will continue until otherwise directly discontinued via the email un-subscribe option. Thank you for your understanding.

Yes, Please keep me updated with your newsletter updates.

Yes, Please contact me about other group programs

Yes, Please contact me about Individual Music Therapy

No Thanks

Signature

By "signing" here, I authorize Integrated Therapy of Northern Colorado to provide group music therapy services to me/my young adult. I understand that my/my child's information will be protected to the most reasonable degree. (At this time, this form is not HIPAA compliant.)