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Mid America Freedom Band
Membership Agreement and Emergency Contact Information
Email address *
Name *
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Occupation *
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Employer
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Instrument *
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Street Address *
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Apartment Number
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City *
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State *
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Zip Code *
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Best Contact Phone *
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Secondary Phone
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Emergency Contact *
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Emergency Contact Phone *
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Please check ensembles you are interested in/are performing in. *
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If participating in concert band, please check the concerts that you plan to perform in. *
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