Brock Middle School Music Department Contact Information Form
Please include the MOST RELEVANT contact information (especially email), so that any important updates reach you as quickly as possible. Information collected in this form will remain confidential.
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Parent name (First, Last) *
Child(ren)'s name(s)? (First, last) *
My child(ren) and I have READ  and DISCUSSED the music department's "Commitment Agreement" information as emailed and /or posted on Mr. Schill's blog and Facebook's "Brock Music Parent/Student Group 2022/2023" *
In which ensemble is/are your child(ren) enrolled? (check all that apply) *
Required
Please provide YOUR primary phone number. *
Please provide YOUR secondary phone number (if applicable).
Please provide YOUR CHILD(REN)'s email address.
Are you, your child(ren)'s primary contact? *
If you answered "No/'It's complicated'", please provide the primary contact's name, email address, and phone number.
Finally, is there any additional information that the BMS Music Dept. Staff should know to help us better serve your child(ren)? (ex. other contact info, etc.)
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