Registration | Legacy Production Co

We’d love to see you join Legacy! Fill out the following with the required information

First name

Last name

Phone

Birthday

Address

Primary Instrument

Secondary Instrument

Emergency Contact First Name

Emergency Contact Last Name

Emergency Contact Email

Emergency Contact Phone Number

MEDICAL INFORMATION

Do you have medical insurance?

Yes

If yes, please upload medical insurance informations for our records

Upload File

I, the undersigned, being the member or parent/legal guardian of the member, hereby authorize any necessary medical treatment.

I/We authorize the administration of any medications prescribed by a doctor in attendance of this member while under the supervision of Legacy Production Co. while at rehearsal and on any approved trips

I/We guarantee payment of any charges incurred during medical treatment.

I/We hereby certify that the above information in current and correct.

Please use mouse on desktop to sign or finger on screen for mobile.

Member Signature

If Member is under 18, Please have parent/Legal Guardian

We’d love to see you join Legacy! Fill out the following with the required information

Thanks for registering.
We will contact you soon!

Join our mailing list

We’d love to see you join Legacy! Fill out the following with the required information

Thanks for registering. We will contact you soon!

Join our mailing list

Thanks for registering.
We will contact you soon!