Soundscapes Daily Program Registration (2023-2024 Season)
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Eligibility
Welcome! We are excited for you to register for our Daily Program at Carver and Greenwood.

New Students: We are accepting rising 2nd graders through rising 4th graders at both Carver and Greenwood Elementary Schools. New students will be selected via lottery in September 2023

Returning Students: Current Soundscapes students will automatically gain entrance into the program as long as they are re-registered for the 2022-2023

***If you are interested in Peninsula Youth Orchestra please fill out this audition form even if the student plans to also participate in the Daily Program: https://forms.gle/VGt7RvHi6if6T6dF6 

Take a virtual program tour ---> http://soundscapes.org/about/program-tour 
Learn more about Soundscapes' program ---> http://soundscapes.org/program

Program Site *
You must be a student at one of these schools.
Required
New or Returning? *
You must be a student at one of these schools.
Student Information
First Name *
Last Name *
Date of Birth *
Sex *
Classroom # *
Lunch Number (Student ID #) *
Grade *
Ethnicity *
Race (please select all that apply) *
Required
Does your child have an Individual Education Program (IEP)? *
Does your child have any allergies (food/other), health problems, or religious observances that we should know about?
Family Information
Home Street Address *
City *
State *
Zip Code *
Primary Phone Number *
Are parent or guardian employed by any of the following organizations?
Does your child have a sibling currently enrolled in Soundscapes? *
Required
If a sibling is currently enrolled in Soundscapes, what is their first and last name?
Financial Information
In order for Soundscapes to make this after school program accessible, we must collect some basic financial information about your family. This personal information will be kept confidential and will not be shared outside the organization on an individual basis. This information is required for enrollment in Soundscapes.
Total Household Family Size (Including adults) *
Select the number closest to your family's total annual household income from all sources *
Transportation
Bus stop MAY be different than the student's regular stop. Please note: If you would like to use a daycare stop, a daycare request form must be filled out in the Main office THIS current school year. All bus stops must be within the site's bus zone.
Transportation: This year, my child will: *
Primary Contact Information
Your contact information is used to contact you about Soundscapes program related information only. This information will remain confidential.
Parent/Guardian #1 Full Name: *
(PG1) Work Phone Number:
(PG1) Home address (if different from child's address):
(PG1) Mobile Phone Number: *
(PG1) E-mail address: *
Parent/Guardian #2 full name:
(PG2) Work Phone Number:
(PG2) Home Address (if different from child's address):
(PG2) Mobile Phone Number:
(PG2) Email:
Emergancy Contact Information
Persons authorized to pick up child (other than parent) OR to contact in case of emergency. These contacts must be different than those listed above, and there must be at least one name.
EC-1 Full Name: *
EC-1 Relationship to child: *
EC-1 Phone Number: *
EC-2 Full Name:
EC-2 Relationship to child:
EC-2 Phone Number:
EC-3 Full Name:
EC-3 Relationship to child:
EC-3 Phone Number:
Photo and Video Release
By participating in Soundscapes, I give permission and consent for the above named child to be photographed, interviewed, or video recorded during program activities. I further give permission and consent that any such media may be published via any media medium (i.e. print, broadcast, internet or any other available medium) and used by Soundscapes and its agents, to illustrate and promote the program experience.

Photo/Video Release Initials *
School Records Release
By participating in Soundscapes, I authorize the release of records for the above named child to Soundscapes.  These records may include, but are not limited to, student educational records, IEP (if applicable), eligibility minutes, psychological reports, sociological history reports, educational reports and medical/health records.

School Records Release Initials *
Digital Signature
By writing your full name (first and last name) you agree to the above-mentioned terms and conditions, and verify that all of the information provided is accurate to the best of your knowledge.
Digital Signature: Type First and Last Name *
Submit
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