Summer Music at the Augusta Registration
Register for our summer music program!
Student First Name
Your answer
Student Last Name
Your answer
Grade in the Fall
What Sessions are you registering for?
AM Program Course
Primary Instrument
Do you need to borrow an instrument for our program? (if you select yes we will lend you an instrument to use during the two weeks of the program)
Home Address
Your answer
Home Phone
Your answer
Cell Phone
Your answer
Email Address
Your answer
Name of an Emergency Contact
Your answer
Emergency Contact Phone Number
Your answer
What is the relationship of the Emergency Contact to the Student?
Your answer
Please list any allergies or medical information about your child that we should be concerned about. If there is nothing, please type NONE.
Your answer
Transportation:
Photo and Video Consent: We may take photos or videos of students as they perform or participate in our program. Do we have your permission to include images of your child on our website, newspaper submissions, or recruiting materials?
Student's T-shirt Size (adult sizes)
Does your child qualify for free or reduced lunch? (we ask so that we can apply for grants)
Breakfast and Lunch Program: This year we are offering free breakfast and lunch from the Greater Meriden Summer Meals Program to all of our participants regardless of financial background. Breakfast will be 8-8:30am and Lunch at 11:30-12:30. Please let us know if you plan on taking advantage of our meal program. A menu will be offered on the first day of the program.
Are you applying for a scholarship?
If you are applying for a scholarship, please explain your circumstances below. You may be asked for further information such as tax forms.
Your answer
Parent Signature: "I allow my child to participate in the Summer Music at the Augusta Program" (please type your full name)
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Meriden Public Schools. Report Abuse - Terms of Service - Additional Terms