<p><div class="et_pb_section et_pb_section_3 et_pb_fullwidth_section et_section_regular" >
				
				
				
				
				
				
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				<img decoding="async" width="1400" height="440" src="https://www.tucsonmariachi.org/wp-content/uploads/2017/01/register-page.jpg" alt="" title="" srcset="https://www.tucsonmariachi.org/wp-content/uploads/2017/01/register-page.jpg 1400w, https://www.tucsonmariachi.org/wp-content/uploads/2017/01/register-page-600x189.jpg 600w, https://www.tucsonmariachi.org/wp-content/uploads/2017/01/register-page-300x94.jpg 300w, https://www.tucsonmariachi.org/wp-content/uploads/2017/01/register-page-768x241.jpg 768w, https://www.tucsonmariachi.org/wp-content/uploads/2017/01/register-page-1024x322.jpg 1024w, https://www.tucsonmariachi.org/wp-content/uploads/2017/01/register-page-1080x339.jpg 1080w" sizes="(max-width: 1400px) 100vw, 1400px" class="wp-image-880" />
			
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				<div class="et_pb_row et_pb_row_3">
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				<div class="et_pb_module et_pb_code et_pb_code_0">
				
				
				
				
				<div class="et_pb_code_inner">
                <div class='gf_browser_chrome gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_17' style='display:none'><div id='gf_17' class='gform_anchor' tabindex='-1'></div>
                        <div class='gform_heading'>
                            <h2 class="gform_title">2025 Registration - Individual</h2>
                            <p class='gform_description'></p>
                        </div><form method='post' enctype='multipart/form-data'  id='gform_17'  action='/?s#gf_17' data-formid='17' novalidate>
        <div id='gf_progressbar_wrapper_17' class='gf_progressbar_wrapper' data-start-at-zero=''>
        	<p class="gf_progressbar_title">Step <span class='gf_step_current_page'>1</span> of <span class='gf_step_page_count'>2</span><span class='gf_step_page_name'></span>
        	</p>
            <div class='gf_progressbar gf_progressbar_blue' aria-hidden='true'>
                <div class='gf_progressbar_percentage percentbar_blue percentbar_50' style='width:50%;'><span>50%</span></div>
            </div></div>
                        <div class='gform-body gform_body'><div id='gform_page_17_1' class='gform_page ' data-js='page-field-id-0' >
					<div class='gform_page_fields'><div id='gform_fields_17' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id="field_17_1" class="gfield gfield--type-select gfield--input-type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_17_1'>Workshop Type<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='ginput_container ginput_container_select'><select name='input_1' id='input_17_1' class='medium gfield_select'    aria-required="true" aria-invalid="false" ><option value='' selected='selected' class='gf_placeholder'>Please select one</option><option value='Mariachi' >Mariachi</option><option value='Folklorico' >Folklorico</option></select></div></div><fieldset id="field_17_3" class="gfield gfield--type-name gfield--input-type-name gfield--width-full field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Individual Name</legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_17_3'>
                            
                            <span id='input_17_3_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >
                                                    <label for='input_17_3_3' class='gform-field-label gform-field-label--type-sub '>First</label>
                                                    <input type='text' name='input_3.3' id='input_17_3_3' value=''   aria-required='false'     />
                                                </span>
                            
                            <span id='input_17_3_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >
                                                            <label for='input_17_3_6' class='gform-field-label gform-field-label--type-sub '>Last</label>
                                                            <input type='text' name='input_3.6' id='input_17_3_6' value=''   aria-required='false'     />
                                                        </span>
                            
                        </div><div class='gfield_description' id='gfield_description_17_3'>The person filling out this form should enter their information here</div></fieldset><fieldset id="field_17_4" class="gfield gfield--type-address gfield--input-type-address gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Individual Address</legend>    
                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip ginput_container_address gform-grid-row' id='input_17_4' >
                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_17_4_1_container' >
                                        <input type='text' name='input_4.1' id='input_17_4_1' value=''    aria-required='false'    />
                                        <label for='input_17_4_1' id='input_17_4_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address</label>
                                    </span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_17_4_3_container' >
                                    <input type='text' name='input_4.3' id='input_17_4_3' value=''    aria-required='false'    />
                                    <label for='input_17_4_3' id='input_17_4_3_label' class='gform-field-label gform-field-label--type-sub '>City</label>
                                 </span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_17_4_4_container' >
                                        <select name='input_4.4' id='input_17_4_4'     aria-required='false'    ><option value='' selected='selected'></option><option value='Alabama' >Alabama</option><option value='Alaska' >Alaska</option><option value='American Samoa' >American Samoa</option><option value='Arizona' >Arizona</option><option value='Arkansas' >Arkansas</option><option value='California' >California</option><option value='Colorado' >Colorado</option><option value='Connecticut' >Connecticut</option><option value='Delaware' >Delaware</option><option value='District of Columbia' >District of Columbia</option><option value='Florida' >Florida</option><option value='Georgia' >Georgia</option><option value='Guam' >Guam</option><option value='Hawaii' >Hawaii</option><option value='Idaho' >Idaho</option><option value='Illinois' >Illinois</option><option value='Indiana' >Indiana</option><option value='Iowa' >Iowa</option><option value='Kansas' >Kansas</option><option value='Kentucky' >Kentucky</option><option value='Louisiana' >Louisiana</option><option value='Maine' >Maine</option><option value='Maryland' >Maryland</option><option value='Massachusetts' >Massachusetts</option><option value='Michigan' >Michigan</option><option value='Minnesota' >Minnesota</option><option value='Mississippi' >Mississippi</option><option value='Missouri' >Missouri</option><option value='Montana' >Montana</option><option value='Nebraska' >Nebraska</option><option value='Nevada' >Nevada</option><option value='New Hampshire' >New Hampshire</option><option value='New Jersey' >New Jersey</option><option value='New Mexico' >New Mexico</option><option value='New York' >New York</option><option value='North Carolina' >North Carolina</option><option value='North Dakota' >North Dakota</option><option value='Northern Mariana Islands' >Northern Mariana Islands</option><option value='Ohio' >Ohio</option><option value='Oklahoma' >Oklahoma</option><option value='Oregon' >Oregon</option><option value='Pennsylvania' >Pennsylvania</option><option value='Puerto Rico' >Puerto Rico</option><option value='Rhode Island' >Rhode Island</option><option value='South Carolina' >South Carolina</option><option value='South Dakota' >South Dakota</option><option value='Tennessee' >Tennessee</option><option value='Texas' >Texas</option><option value='Utah' >Utah</option><option value='U.S. Virgin Islands' >U.S. Virgin Islands</option><option value='Vermont' >Vermont</option><option value='Virginia' >Virginia</option><option value='Washington' >Washington</option><option value='West Virginia' >West Virginia</option><option value='Wisconsin' >Wisconsin</option><option value='Wyoming' >Wyoming</option><option value='Armed Forces Americas' >Armed Forces Americas</option><option value='Armed Forces Europe' >Armed Forces Europe</option><option value='Armed Forces Pacific' >Armed Forces Pacific</option></select>
                                        <label for='input_17_4_4' id='input_17_4_4_label' class='gform-field-label gform-field-label--type-sub '>State</label>
                                      </span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_17_4_5_container' >
                                    <input type='text' name='input_4.5' id='input_17_4_5' value=''    aria-required='false'    />
                                    <label for='input_17_4_5' id='input_17_4_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP Code</label>
                                </span><input type='hidden' class='gform_hidden' name='input_4.6' id='input_17_4_6' value='United States' />
                    <div class='gf_clear gf_clear_complex'></div>
                </div><div class='gfield_description' id='gfield_description_17_4'>The person filling out this form should enter their information here</div></fieldset><div id="field_17_5" class="gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_17_5'>Individual Email<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='ginput_container ginput_container_email'>
                            <input name='input_5' id='input_17_5' type='email' value='' class='large'    aria-required="true" aria-invalid="false" aria-describedby="gfield_description_17_5" />
                        </div><div class='gfield_description' id='gfield_description_17_5'>The person filling out this form should enter their information here</div></div><div id="field_17_24" class="gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><p><strong>By entering your cell phone number you agree to receive text messages from TIMC.  Reply HELP for help, and STOP to opt-out. Msg & Data Rates May Apply. 
<br><br>
SMS SHARING DISCLOSURE: No mobile data will be shared with third parties/affiliates for marketing/promotional purposes at any time.</strong></p></div><div id="field_17_7" class="gfield gfield--type-phone gfield--input-type-phone gfield--width-half gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_17_7'>Cell Phone<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='ginput_container ginput_container_phone'><input name='input_7' id='input_17_7' type='tel' value='' class='large'   aria-required="true" aria-invalid="false" aria-describedby="gfield_description_17_7"  /></div><div class='gfield_description' id='gfield_description_17_7'>The person filling out this form should enter their information here</div></div><div id="field_17_6" class="gfield gfield--type-phone gfield--input-type-phone gfield--width-half field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_17_6'>Daytime Phone</label><div class='ginput_container ginput_container_phone'><input name='input_6' id='input_17_6' type='tel' value='' class='large'    aria-invalid="false" aria-describedby="gfield_description_17_6"  /></div><div class='gfield_description' id='gfield_description_17_6'>The person filling out this form should enter their information here</div></div><fieldset id="field_17_20" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label' >Will you be staying at a hotel during the conference?</legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_17_20'>
			<div class='gchoice gchoice_17_20_0'>
					<input class='gfield-choice-input' name='input_20' type='radio' value='Yes'  id='choice_17_20_0' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_17_20_0' id='label_17_20_0' class='gform-field-label gform-field-label--type-inline'>Yes</label>
			</div>
			<div class='gchoice gchoice_17_20_1'>
					<input class='gfield-choice-input' name='input_20' type='radio' value='No'  id='choice_17_20_1' onchange='gformToggleRadioOther( this )'    />
					<label for='choice_17_20_1' id='label_17_20_1' class='gform-field-label gform-field-label--type-inline'>No</label>
			</div></div></div></fieldset><div id="field_17_23" class="gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_17_23'>Which hotel will you be staying at?</label><div class='ginput_container ginput_container_text'><input name='input_23' id='input_17_23' type='text' value='' class='large'      aria-invalid="false"   /></div></div></div>
                    </div>
                    <div class='gform-page-footer gform_page_footer top_label'>
                         <input type='button' id='gform_next_button_17_18' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  /> 
                    </div>
                </div>
                <div id='gform_page_17_2' class='gform_page' data-js='page-field-id-18' style='display:none;'>
                    <div class='gform_page_fields'>
                        <div id='gform_fields_17_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id="field_17_8" class="gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Participant&#039;s Name<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_17_8'>
                            
                            <span id='input_17_8_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >
                                                    <input type='text' name='input_8.3' id='input_17_8_3' value=''   aria-required='true'   placeholder='Participant&#039;s First Name'  />
                                                    <label for='input_17_8_3' class='gform-field-label gform-field-label--type-sub '>First</label>
                                                </span>
                            
                            <span id='input_17_8_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >
                                                    <input type='text' name='input_8.6' id='input_17_8_6' value=''   aria-required='true'   placeholder='Participant&#039;s Last Name'  />
                                                    <label for='input_17_8_6' class='gform-field-label gform-field-label--type-sub '>Last</label>
                                                </span>
                            
                        </div></fieldset><div id="field_17_9" class="gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_17_9'>Participant&#039;s Age<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='ginput_container ginput_container_number'><input name='input_9' id='input_17_9' type='number' step='any' min='0' max='99' value='' class='small'     aria-required="true" aria-invalid="false" aria-describedby="gfield_instruction_17_9" /><div class='gfield_description instruction ' id='gfield_instruction_17_9'>Please enter a number from <strong>0</strong> to <strong>99</strong>.</div></div></div><div id="field_17_10" class="gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_17_10'>Participant&#039;s Gender<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='ginput_container ginput_container_select'><select name='input_10' id='input_17_10' class='large gfield_select'    aria-required="true" aria-invalid="false" ><option value='' selected='selected' class='gf_placeholder'>Please select one</option><option value='Male' >Male</option><option value='Female' >Female</option></select></div></div><div id="field_17_11" class="gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_17_11'>Participant&#039;s Race<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='ginput_container ginput_container_select'><select name='input_11' id='input_17_11' class='large gfield_select'    aria-required="true" aria-invalid="false" ><option value='' selected='selected' class='gf_placeholder'>Please select one</option><option value='African American' >African American</option><option value='Asian American' >Asian American</option><option value='Hispanic' >Hispanic</option><option value='Mexican American' >Mexican American</option><option value='Native American' >Native American</option><option value='White' >White</option><option value='Other' >Other</option></select></div></div><div id="field_17_12" class="gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_17_12'>Participant&#039;s Grade<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='ginput_container ginput_container_select'><select name='input_12' id='input_17_12' class='large gfield_select'    aria-required="true" aria-invalid="false" ><option value='' selected='selected' class='gf_placeholder'>Please select one</option><option value='Elementary School' >Elementary School</option><option value='Middle School' >Middle School</option><option value='High School' >High School</option><option value='College' >College</option><option value='N/A' >N/A</option></select></div></div><div id="field_17_13" class="gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_17_13'>Participant&#039;s Class<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='ginput_container ginput_container_select'><select name='input_13' id='input_17_13' class='large gfield_select'    aria-required="true" aria-invalid="false" ><option value='' selected='selected' class='gf_placeholder'>Please select one</option><option value='Dance' >Dance</option><option value='Guitar' >Guitar</option><option value='Guitarron' >Guitarron</option><option value='Harp' >Harp</option><option value='Trumpet' >Trumpet</option><option value='Vihuela' >Vihuela</option><option value='Violin' >Violin</option><option value='Voice' >Voice</option></select></div></div><div id="field_17_17" class="gfield gfield--type-product gfield--input-type-select gfield--width-half gfield_price gfield_price_17_17 gfield_product_17_17 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  ><label class='gfield_label gform-field-label' for='input_17_17'>Participant&#039;s Level<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='ginput_container ginput_container_select'><select name='input_17' id='input_17_17' class='large gfield_select'    aria-required="true" aria-invalid="false" ><option value='' selected='selected' class='gf_placeholder'>Please select one</option><option value='I|115' >I</option><option value='II|115' >II</option><option value='III|115' >III</option><option value='Master|165' >Master</option></select></div></div><div id="field_17_16" class="gfield gfield--type-total gfield--input-type-total gfield--width-full gfield_price gfield_price_17_ gfield_total gfield_total_17_ field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"  aria-atomic="true" aria-live="polite" ><label class='gfield_label gform-field-label' for='input_17_16'>Total</label><div class='ginput_container ginput_container_total'>
							<input type='text' readonly name='input_16' id='input_17_16' value='$0.00' class='gform-text-input-reset ginput_total ginput_total_17' />
						</div></div><div id="field_17_15" class="gfield gfield--type-stripe_creditcard gfield--input-type-stripe_creditcard gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--type-stripe_creditcard-card"  ><label class='gfield_label gfield_label_before_complex gform-field-label' for='input_17_15_1'>Credit Card<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='ginput_complex ginput_container ginput_container_creditcard ginput_stripe_creditcard gform-grid-row' id='input_17_15'><div class='ginput_full gform-grid-col' id='input_17_15_1_container' data-payment-element='false'><div id='input_17_15_1' class='gform-theme-field-control StripeElement--card'></div><label for='input_17_15_1' id='input_17_15_1_label' class='gform-field-label gform-field-label--type-sub'>Card Details</label></div><!-- .ginput_full --><div class='ginput_full gform-grid-col' id='input_17_15_5_container'>
					<input type='text' name='input_15.5' id='input_17_15_5' value=''>
					<label for='input_17_15_5' id='input_17_15_5_label' class='gform-field-label gform-field-label--type-sub'>Cardholder Name</label>
				</div></div><!-- .ginput_container -->
			<style type="text/css">
				:root {
  					--link-login-string: "Link login"
				}
			</style></div></div></div>
        <div class='gform-page-footer gform_page_footer top_label'><input type='submit' id='gform_previous_button_17' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  /> <input type='submit' id='gform_submit_button_17' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='Submit'  /> 
            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_17' value='postback' />
            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_17' id='gform_theme_17' value='gravity-theme' />
            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_17' id='gform_style_settings_17' value='[]' />
            <input type='hidden' class='gform_hidden' name='is_submit_17' value='1' />
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            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' />
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PARTICIPANT RELEASE FORM<br />
A MEDICAL RELEASE FORM AND PHOTO/PUBLICITY FORM, MUST BE SIGNED BY ALL PARTICIPANTS OR PARENT/GUARDIAN OF PARTICIPANTS UNDER AGE 18. THIS FORM IS REQUIRED.Make copies of this form as needed, and email a copy to Teri Lagunas at  info@tucsonmariachi.org<br />
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