Emergency Contact & Uniform Profile Form 2019
This online form must be completed in addition to the paperwork packet that was handed out for the 2019 Jenison Marching Band.
Student Last Name *
Your answer
Student First Name *
Your answer
Student Date of Birth *
MM
/
DD
/
YYYY
Student Grade 2019-2020 *
Student Street Address (house number and street) *
Your answer
City, State and Zip Code *
Your answer
Student Cell Phone Number (please include area code) *
Your answer
Parent/Guardian 1 (First and Last Name) *
Your answer
Parent/Guardian 1 Email Address *
Your answer
Parent/Guardian 1 Phone Number (please include area code) *
Your answer
Parent/Guardian 2 (First and Last Name)
Your answer
Parent/Guardian 2 Email Address
Your answer
Parent/Guardian 2 Phone Number (please include area code)
Your answer
Email Address(es) that you would like used for the Jenison Bands Email Service: *
Your answer
Emergency Contact Full Name (with whom student does not reside) *
Your answer
Relation of Emergency Contact Person to Student *
Your answer
Emergency Contact Phone (please include area code) *
Your answer
Emergency Contact Work Phone (please include area code)
Your answer
Next
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