FENTON MARCHING TIGERS 2019 REGISTRATION FORM
Student Information and Parent Authorization Form

**This form will serve as authorization for all band related activities July 2019 thru May 2020**
PLEASE KEEP ALL INFO UP-TO-DATE AS IT WILL BE USED FOR THE ENTIRE SEASON

Due NO LATER THAN MAY 17, 2019:
*Online submission of THIS FORM,
*Full PAYMENT submitted with Signed MARCHING BAND SEASON Form (Front & Back), the ICHAT form, the SVSU Form (Checks & Money Orders must be made payable to Fenton Band Boosters).

Student FIRST Name (Legal) *
Your answer
Student FIRST Name (Preferred for Name Tag) *
Your answer
Student Last Name *
Your answer
Marching Band Instrument *
Home Address - House # and Street *
Your answer
Home Address - City *
Your answer
Home Address - Zip Code *
Your answer
Home Phone # *
Please enter the best phone number to contact
Your answer
Grade in 2019-2020 *
Male/Female *
Adult T-Shirt Size *
Uniform Maintenance Fee *
An additional $20 uniform fee will be assessed at the time of uniform fitting in August. THIS FEE CAN BE WAIVED by participating in the Lasco Ford "Drive One" Fundraiser, held simultaneously with uniform fittings. Participation simply means that an adult from your household test drives a new Ford vehicle. There is no cost or obligation. Details to follow.
Will you be purchasing Marching Band Shoes at Camp? *
Father's Name
(First & Last)
Your answer
Father's Cell #
Your answer
Father's Email
Your answer
Mother's Name
(First & Last)
Your answer
Mother's Cell #
Your answer
Mother's Email
Your answer
Who is the Primary Contact? *
(The first person to contact for basic questions and/or emergencies)
Student's Cell # *
If applicable
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Phone # *
Your answer
Roomate Requests *
Note: Suites hold 6-8 people. Requests are not guaranteed, but every possible effort is made. It HELPS if students get together to arrange roommates BEFORE submitting this form. We never know how many of each room type we get until just prior to camp. If potential room mates change after form is submitted, email bandcamp.fentonband@gmail.com with any changes, and only if absolutely necessary.
Your answer
Is there anyone it would be better to NOT be placed with in a room?
Please list names if necessary
Your answer
Student's Date of Birth *
MM
/
DD
/
YYYY
Family Doctor Name
Your answer
Family Doctor Phone #
Your answer
Date of Last Tetanus Booster
Your answer
All Known Allergies *
List NONE if appropriate
Your answer
Medication now taking
List all - Please note a more complete medical form will be required prior to camp for dosages
Your answer
ANY OTHER MEDICAL CONCERNS OF WHICH WE SHOULD BE AWARE?
Your answer
Medical Insurance Company & Policy Number *
List NONE if the student does not have Health Insurance
Your answer
Parent or Guardian Authorization *
In case of an accident or serious illness, I hereby authorize Fenton High School personnel or parent chaperone to incur medical costs necessary to secure medical treatment for the above listed child, for which I shall be fully responsible. I also authorize the medical facility to release any and all information required to complete insurance claims and also authorize insurance payment directly to the medical facility.
Required
I hereby give my permission for Andrew David Perkins or his representative to administer the following over-the-counter medications if necessary.
Check All You Approve - Please note if the boxes are NOT checked and your child needs some medication, you will have to be contacted by phone before it is given.
Parent or Guardian Authorization *
I understand that in the event my son/daughter does not comply by the rules given, they will lose the privilege of participating in marching band. Consequences may include suspension and/or expulsion at the discretion of the director and/or administrator. Violations include and are not limited to: Possessing illegal drugs, cigarettes or alcohol; inappropriate conduct, causing harm to another person, causing damage to property. In case of a serious disciplinary problem, I hereby authorize Fenton Area Public Schools personnel to send this student home. It is understood that such a return trip would be at the parent's expense. Parents will be notified before this action is taken.
Required
PHOTO CONSENT *
In consideration of participation in any of the Fenton High School Music programs, I (the parent or legal guardian of participant) release Fenton High School, its licensees, agents, successors and assigns including, but not limited to the Fenton Band Boosters (hereinafter collectively referred to as “FHS”) from all liability for claims and demands arising out of this consent form as set forth below. I authorize FHS to fix participant’s picture or likeness, voice, or any performance in any tangible medium of expression now known or later developed, from which can be perceived, reproduced, or otherwise communicated as a “recording”, either directly or with the aid of a machine or device including, but not limited to photographs, films and audio- and videotapes, and compact disks; to edit these recordings at FHS’ discretion; to incorporate these recordings into movie and sound films, audio- and videotapes, compact disks, or broadcast programs (radio and television, including cable and satellite transmissions); to use and license others to use such recordings, movie and sound films, audio- and videotapes, compact disks, or broadcast programs in any manner of media whatsoever, including unrestricted use for purposes of publicity, advertising and sales promotion and to use participant’s likeness, voice, performance and biographic or other information in connection with the recording. I further agree to indemnify and hold harmless FHS from any and all claims and liability for damages, losses or expenses of any sort arising from the making of such recordings and their use. I further acknowledge that, there were no promises of any compensation for such use by FHS and that FHS exclusively owns all rights to these recordings regardless of the form in which they are produced or used. I agree that I have fully read and understand the contents of this consent form, and that I have the full legal right and authority to accept and agree to the terms within this consent form.
Required
Parent or Guardian Authorizing this Form
Please enter first & last name
Your answer
Student Agreement *
I will follow all the school and band class rules. I understand that in the event I do not comply by the rules given, I will lose the privilege of participating in marching band. Consequences may include suspension and/or expulsion at the discretion of the director and/or administrator. Violations include and are not limited to: Possessing illegal drugs, cigarettes or alcohol; inappropriate conduct, causing harm to another person, causing damage to property. In case of a serious disciplinary problem, I understand I will be sent home. It is understood that such a return trip would be at my parent's expense. Parents will be notified before this action is taken.
Required
Date
MM
/
DD
/
YYYY
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