Prospective Panther Night/Middle School Night
Welcome! Please complete this form to register for Middle School Night with the Dillard High School Marching Band. This information helps us prepare for your visit. All fields are required. 
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Email *
Student First and Last name *
Student ID (06) Number *
Current Middle School  *
Instrument  *
Parent/Guardian First and Last Name *
Parent/Guardian Phone Number *
Parent/Guardian Email Address *
T-Shirt Size *
Dietary Restrictions or Allergies  *
Will you need to borrow an instrument?  *
(Yes/No – if yes, please explain)

Media Release Consent
Dillard High School may take photos or videos during Middle School Night for promotional or educational purposes. These may be used on the school website, social media, or in print materials.

 *

Do you give permission for your child to be photographed or recorded during this event?

Required
Signature or N/A *
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