Registration Form CHHS Band Registration 2021-2022 Step 1 of 7 14% Student General InformationHiddenCHHSid Student Name* First Last Student ID* Grade 2021-2022 (Starting in FALL 2021)*9th (Freshman)10th (Sopomore)11th (Junior)12th (Senior)Gender*MaleFemaleStudent Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Date of Birth* MM slash DD slash YYYY Student Cell Phone NumberT-Shirt Size*SmallMediumLargeX-LargeXX-LargeInstrument*FluteOboeBassoonClarinetBass ClarinetAlto SaxTenor SaxBari SaxTrumpetHornTromboneEuphoniumTubaPercussionColor GuardSelect Program Involvement*Concert Band OnlyMarching and Concert BandColorguard OnlyColorguard & Concert Band Parent/Guardian InformationParent 1: InformationParent 1 Name* First Last Parent 1 Occupation Parent 1 Email* Parent 1 Cell Phone*Parent 1 Work PhoneParent 1 Address (if different from Student) Street Address City State ZIP Parent 2 InformationParent 2 Name First Last Parent 2 Occupation Parent 2 Email Parent 2 Cell PhoneParent 2 Work PhoneParent 2 Address (if different from Student) Street Address City State ZIP Emergency InformationMedical ContactInsurance*YesNoInsurance Carrier Policy Holder's Name Policy # Group # Emergency ContactEmergency Contact Name* First Last Emergency Contact Relationship* Emergency Contact Phone* Emergency Information - ContinuedIs your student allergic to anything?*Pick OneYesNoPlease Explain AllergiesEpiPen? My child carries an EpiPen (or equivalent product) that must stay with them at all times. Does your student have any dietary restrictions?*Pick OneYesNoPlease explain in detail foods your student cannot eatIs your student taking any medications regularly?*YesNoList any medications your student is currently taking:List any medications your student will need to take while at camp/practices (reminder that students are not allowed to have medication on them at anytime. All medications (including Over The Counter medications, must be in the possession of the nurses at all times):MedicationsPlease check if any of the below medication may be dispensed to your studentBy placing a check in front of the medicine you authorize this medicine to be dispensed to your student. Tylenol (acetaminophen) Advil / Motrin (ibuprofen) Antacid (Rolaids, etc.) Benadryl Explain any other medical conditions or circumstances we should be aware of and how they should be handled if a family member or emergency contact cannot be reached: Volunteer Opportunities Parental support and participation is VITAL to our success! VOLUNTEERING to help with dinners, fundraisers, sewing flags, fitting uniforms, moving equipment, building props, organizing carpools, chaperoning, etc. For those who choose to become involved, the band becomes like a second family. We want all of our members to be and feel like part of our family! All parents are required to adhere to the Volunteer Obligation Policy. The volunteer requirements for participation as outlined (25 Hours per family - which includes 5 hours for mandatory concessions work at a football game)**Volunteer RolesPlease select ALL areas you may be interested in helping. Chaperones Roadies Uniform Parent Corner Field Equipment Mover (Truck Required) Nurse/Medical (Marching Only) Eagles Nest Invitational (Marching Band Competition at CHHS) Board Position (Elected, but helps us know you are interested) Not sure yet, please check back with us. First Choice: Concessions (Required)*We ask that a family member form EVERY family work concessions for 1 football game. If you are a parent of a senior PLEASE do not select 10/22. Please select your FIRST CHOICE (You will only work one game) 9/17 vs Alpharetta 9/24 vs East Coweta 10/1 vs Peachtree Ridge 10/22 vs Mountain View (Senior Night) Second Choice: Concessions (Required)*We ask that a family member form EVERY family work concessions for 1 football game. If you are a parent of a senior PLEASE do not select 10/22. Please select your SECOND CHOICE (You will only work one game) 9/17 vs Alpharetta 9/24 vs East Coweta 10/1 vs Peachtree Ridge 10/22 vs Mountain View (Senior Night) OtherIf you know of other ways you can assist the band please note them below. I agree (Must Check Below)*AGREE: I hereby acknowledge receipt and understanding of the financial obligation policy. All payments are non-refundable. Please understand that if your student decides to quit for any reason, that student is responsible for all payments due up until the date of departure. For example, if your child signs up for marching band and quits before camp starts, they are still responsible for all payments up until we are notified of the departure. Likewise if a student quits in the middle of the season, they are still responsible for all payments due up until the day they quit. By digitally agreeing, I agree to abide by the policy and meet the financial requirements (amount due & due dates) for participation as outlined in the tables on the this page. I understand that failure to meet the required financial commitments WILL RESULT in my band member being denied participation in any or all parts of the 2021-2022 Marching & Concert Band programs. I Agree Concert Band - Costs Concert Band Payment $200 OTHER FEES FOR CONCERT BAND (AS REQUIRED) Concert Band Uniform - $100-$130 (Sept 2021) Instrument Rental Fee - $30 per semesterDistrict Band Auditions - $30 (Sept. 2021) All State Jazz Auditions - $30 (Sept. 2021) Jazz Band - $50 (December 2021)Locker Fee - $5 (January 2021) I agree (Must Check Below)*I hereby acknowledge receipt of the financial obligation policy. By digitally agreeing, I agree to abide by the policy and meet the financial requirements (amount due & due dates) for participation as outlined in the tables on the first page. I understand that failure to meet the required financial commitments WILL RESULT in my band member being denied participation in any or all parts of the 2021-22 Concert Band Program I Agree
