“Song of Love” Office Request Form

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Child Info

(All fields with an * are required and must be filled in. Please make sure form is completely filled out before submitting it.)
Haga clic aquí para el perfil en Español.
We will do our best to include all the names given but please limit the amount of the names. If too many are submitted we might not be able to get them all in.
Style of Music (Please check at least 3 of your child's favorite kinds of music)

Parent or Guardian Info

How Did You Hear Of Songs of Love?

Publicity Release

I, the undersigned, hereby grant to Songs of Love Foundaton (Songs of Love) the right, license, and privilege to use my name, likeness, photograph, voice, and biography, as well as the "Song of Love" written for the above-named child in such a manner as Songs of Love shall deem appropriate, (including but not limited to fundraising, etc) in order to promote, advertise, and publicize Songs of Love and its charitable activities.
Click or drag a file to this area to upload.
If possible, PLEASE upload a photo of child. (max file size:10mb)