Area Band Registration Form

Area Band
Grades 6, 7 & 8 Band Registration

To be completed by the parent/guardian: (please print clearly)

Name of Student ________________________________________________________

School _______________________________________________ Grade ___________

Parent/Guardian Names ___________________________________________________­

Address __________________________________________Postal Code____________

Parent E-mail Address(es)  _________________________________________________

Parent Telephone(s) (home) ________________(work) ____________(cell)__________

Instrument ______________________________________________________________

Grade 6 registrants please indicate a second choice instrument _______________________________

The annual fee of $50.00 for transportation is payable on or before the last day of September. It is preferred that all payments be made online. If a cheque has to be used, it must be payable to your school. The student’s name and grade should appear at the bottom of the cheque. Refunds will only be granted before the last day of October and will be adjusted for services provided.

________________________________                    _____________________________           
Parent/Guardian’s Signature                                        Date

To be completed by the Band Teacher

________________________________        Payment Method _____________________        
Band Teacher’s Signature      

#3406-15                                 WHITE: Band Director Copy            YELLOW: Parent/Guardian Copy

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