UNI Spectrum Project Performer Registration

Thank you for your interest in the Spectrum Project. Please complete this registration form to sign your child up for the 2022 Spectrum Project Connections.

After completing registration, you will be emailed a link to a Performer Information Form. This form will ask you to supply additional information about your child that will help us provide an enjoyable and safe experience for them at Spectrum Project.

2022 registration: $15. Payable online.

Dates of all Connections

Feb. 5, 2022

Feb. 19, 2022

March 5, 2022

March 26, 2022

April 9, 2022

April 23, 2022

Questions? Contact Kevin Droe at kevin.droe@uni.edu or 319-273-3073

Performer Information

Performer First Name *

Performer Last Name *

Performer Age *

Performer School *

Parent/Guardian Information

Parent/Guardian First Name *

Parent/Guardian Last Name *

Parent/Guardian E-mail Address *

Parent/Guardian Phone Number *

Where parent/guardian can be reached during Saturday rehearsals (1-2:30 p.m.)

Parent/Guardian Street Address *

Parent/Guardian City *

Parent/Guardian State *

Parent/Guardian Zip *

Parent/Guardian Information #2 (Optional)

Parent/Guardian First Name (2)

Parent/Guardian Last Name (2)

Parent/Guardian E-mail Address (2)

Parent/Guardian Phone Number (2)

Where parent/guardian can be reached during Saturday rehearsals (1-2:30 p.m.).

Parent/Guardian Street Address (2)

Parent/Guardian City (2)

Parent/Guardian State (2)

Parent/Guardian Zip (2)

Parent/Guardian Information #3 (Optional)

Parent/Guardian First Name (3)

Parent/Guardian Last Name (3)

Parent/Guardian E-mail Address (3)

Parent/Guardian Phone Number (3)

Where parent/guardian can be reached during Saturday rehearsals (1-2:30 p.m.).

Parent/Guardian Street Address (3)

Parent/Guardian City (3)

Parent/Guardian State (3)

Parent/Guardian Zip (3)

Video and Media Release

Performers may be video recorded, photographed or audio recorded periodically for educational and promotional purposes. If this media is shared with another party, student names will not be used. Any use of your child's image on SpectrumProject.org will not include last name.

Please select... *

Yes, I or my child can be video recorded, photographed or audio recorded periodically for educational and promotional purposes.

No, please do not share any video recordings or photos.

Name that will appear on the credit card you'll use for payment (if applicable):

Leave this field blank