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STUDENT(S) INFORMATION
First Child`s Name

Age

Grade

Birthdate

CHECK THE ENSEMBLES & INSTRUMENTS THAT THE STUDENT WISHES TO PARTICIPATE IN
Beginning Band

Intermediate Band

Advanced Band














Second Child`s Name

Age

Grade

Birthdate

CHECK THE ENSEMBLES & INSTRUMENTS THAT THE STUDENT WISHES TO PARTICIPATE IN
Beginning Band

Intermediate Band

Advanced Band














Third Child`s Name

Age

Grade

Birthdate

CHECK THE ENSEMBLES & INSTRUMENTS THAT THE STUDENT WISHES TO PARTICIPATE IN
Beginning Band

Intermediate Band

Advanced Band














Fourth Child`s Name

Age

Grade

Birthdate

CHECK THE ENSEMBLES & INSTRUMENTS THAT THE STUDENT WISHES TO PARTICIPATE IN
Beginning Band

Intermediate Band

Advanced Band














FAMILY/CONTACT INFORMATION
PARENTS LAST NAME

PARENTS FIRST NAME

HOME STREET ADDRESS

CITY

STATE

ZIP CODE

HOME PHONE

CELL PHONE

PRIMARY CONTACT

PRIMARY CONTACT

RECIEVE TEXTS
YES NO 

 
E-MAIL*

Please check the ``NO/LIMITED DIGITAL COMMUNICATION`` box if you do
NOT have regular access to e-mail or need notified by phone about any
potential schedule changes, cancelations, or updates.
NO/LIMITED DIGITAL COMMUNICATION

 
FAMILY CHURCH AFFILIATION

HOME SCHOOL ORGANIZATION

Please use the box below to add comments that you think would be helpful
(health conditions, scheduling conflicts, things that your family can contribute
to the band program, etc.).

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