Wufoo

Student Name * First Last
Student Status *
Freshman/New Band Student Veteran/Returning Band Student
Instrument *
Junior High School *
Select current grade level *
Freshman Sophomore Junior Senior
Student Cell Phone * ### - ### - ####
Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Home Phone Number * ### - ### - ####
Parent Name 1 * First Last
Parent 1 Email Address *
Parent 1 Cell Phone * ### - ### - ####
Parent Name 2 * First Last
Parent 2 Email Address *
Parent 2 Cell Phone * ### - ### - ####
Select Shirt Size (Band T-shirt & Concert Dress Shirt) *
Small Medium Large XL 2XL
Shoe Size. Please indicate half sizes. (i.e. 7.5, 8) *
Will you be participating in sports or clubs during the 2016-2017 school year? Please list those below with your coach/sponsor name if possible. (i.e. Freshman Football - Coach Laba) If NONE, please state "NONE". *
Some students require school instruments. Tubas, Mellophones, Marching Baritones, Percussion. Please Select our instrument below. *
Sousaphone - Tuba Euphonium - Marching Baritone Mellophone - French Horn Saxophone - Oboe Players Percussion NO INSTRUMENT NEEDED
Emergency Contact. In an emergency, if a parent/guardian cannot be reached the following person will be contacted: * First Last
Emergency Contact Phone Number * ### - ### - ####
Allergy Information: Please list all allergies (food and environmental) If the student carries an Epipen, or other emergency recovery medication, please include that information. If this section is not applicable, please type "NONE". *
Other Medical Concerns: Please list any other medical concerns that may impact your student's ability to participate in Marchin Band, or conditions that the Band Instructors should be made aware of. Example: Asthma, Anxiety, Heat Intolerance, etc. If not applicable, please type "NONE". *
Band Camp Fees
Returning Band Member (Fee includes: Band Camp Pool Party admission, Band Camp T-Bolt ticket, Game Day Dinners during Marching Season) $100.00 New Band Member (Fee includes:Pool Party, T-Bolt ticket, Band T-Shirt, Marching Shoes, Concert Shirt, Game Day Dinners during Marching Season) $150.00
Do Not Fill This Out