Home School Band Registration

Complete the following information to register for our first Home School Band

Student's First Name Student's Last Name

Gender Male Female

Age Street Address City State Zip Code Father's Name Father's Cell Phone Father's Email Address Mother's Name Mother's Cell Phone Mother's Email Address

If your child has never played an instrument before, check his/her top three (3) choices: Flute Clarinet Alto Saxophone Trumpet Trombone Percussion Violin Viola Cello Bass

Emergency Contact Relationship Cell Phone Comments or Questions

Tuition Payment Options Below

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