2017 Goochland Workshop Online Registration Form

First Name: Name of Church:
Last Name: Church Address:
Address: City: State: Zip:
City State: Zip: Phone: Fax:
Phone: Minister of Music:
Email: Email:
Workshop Fees
Adult Pre-Registration Fee (21 & over until October 7, 2017) - $30.00
Adult Registration Fee (21 & over until October 7, 2017) - $35.00
Youth Pre-Registration Fee (11-20 years) - $20.00 (fee until October 7, 2017)
Youth Registration Fee (11-20 years) - $25.00
Children Pre-Registration Fee (5-10 years) - $10.00 (fee until October 7, 2017)
Children Registration Fee (5-10 years) - $15.00
CHOIR OF CHOICE : Children   |      Youth   |      Adult Mass Choir
POSITION: Minister of Music Choir Director Choir Member Musician
Musicians Instrument of Choice
VOICE: Soprano Alto Tenor Bass                 READ MUSIC :
TITLE: Dr.   Rev.  Minister   Bishop   Pastor   Elder

After Submitting form you will be taken to a page to submit your payment. You must fill out this form first.


Please Read Disclaimer Below *

Disclaimer: I acknowledge as a participant of the GMWA Workshop 2017 , I attend at my own risk. I realize that the Host Church nor the Gospel Music Workshop Of America, Goochland VA & Vicinity Chapter has no legal responsibility or liability to me as a result of my being a participant of this workshop; I agree to not hold either of these establishments accountable or responsible for any injuries or accidents which can or may occurwhile I am in these facilities. I waive all rights to file formal charges or expenses toward any of the above parties.

Participant Name: ___________________

* I have read and understand the disclaimer above