Jenny Lin 2019 Summer Youth Music Program Registration
This form is to be filled out by the participant as well as the parent/guardian. Thanks for your interest in the Jenny Lin Summer Youth Music Program!
Email address *
Student Information
Student First Name *
Your answer
Student Last Name *
Your answer
Student Address *
Your answer
City *
Your answer
Student's Cell Phone
Your answer
Student's Email
Your answer
Parent/Guardian Section
This section is to be filled out by your parent or guardian.
Parent/Guardian Name (First and Last) *
Your answer
Parent/Guardian Phone Number *
Your answer
Parent/Guardian E-mail Address *
Your answer
Additional Emergency Contact
In the event of an emergency and the parent/guardian cannot be reached, we will need an additional emergency contact.
Emergency Contact Name (First and Last) *
Your answer
Emergency Contact Phone Number *
Your answer
Emergency Contact E-mail Address *
Your answer
Relationship to Student *
Your answer
Number of Years in Jenny Lin Program *
Choose Ensemble +
+ Woodwind, Brass and Percussion Players: Please select "band" as your primary program. Non-string players will be selected for orchestra from band players at the end of the first week of attendance.
Select Ensemble *
Next
Never submit passwords through Google Forms.
This form was created inside of Woodwind Web Design. Report Abuse - Terms of Service