Loara Band Registration 2024-2025
Welcome to the Loara Band! Tell us a few things about yourself.
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Email *
Last Name *
First Name *
Student ID *
Grade *
Pronouns
Date of Birth *
MM
/
DD
/
YYYY
What Section of the Band Family are you a part of? *
NON AUHSD EMAIL *
Address (Number, Street, City, Zip) *
Phone Number (Student Cell if you have one) *
Parent Name 1 *
Parent Name 2
Parent Phone 1 *
Parent Phone 2
Parent Email 1 *
Parent Email 2
Medical Insurance Provider (if none write "District") *
Medical Insurance Policy Number (If none write "District") *
Please list any known Allergies or write "none" *
Please list any medications your student takes that we would need to be aware of *
Please list the name and number of an emergency contact *
A copy of your responses will be emailed to the address you provided.
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