Miamisburg Bands Concert Band Registration 2017-2018
Student First Name
Your answer
Student Last Name
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Student ID
Must be 6 digits. Please add a zero to the beginning if your student only has 5 digits.
Your answer
Student Grade
Band in Which Student is Enrolled
Check All That Apply
Required
Parent Email Address #1
Please list all email addresses in which you would like to receive information; if possible, please also list emails for all parents, stepparents, etc.
Your answer
Email Address #2
Your answer
Email Address #3
If more than three email addresses, please list all here, separated by commas
Your answer
Parent Phone Number #1
Your answer
Phone Number #2
Your answer
Phone Number #3
Your answer
Instrument
Required
Instrument Brand (Yamaha, Conn, Gemeinhardt, etc.)
Please answer this only if you play an instrument NOT owned by the Miamisburg City Schools
Your answer
Instrument Serial Number
Please leave blank if you are unsure.
Your answer
Insurer Providing Coverage on Instrument
If Known
Your answer
Terms of Acceptance
Required
Submit
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