PPS Marching Band 2019
Marching Band Signups for Plymouth High Schools Marching Band for fall of 2019.
Please fill out the following information to provide us some information about your student. We are looking forward to getting to know each of them as part of this after school performing group!
Pre-season rehearsals will be scheduled in June and July. Band Camp (full rehearsals) begin on August 12 at Plymouth North High School
Email address *
Student first name *
Your answer
Student last name *
Your answer
Date of birth *
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Home phone number *
Your answer
Emergency contact name *
Your answer
Emergency contact number *
Your answer
Additional emergency contact number
Your answer
Student cell number *
Your answer
Parent email address *
Your answer
Second parent email address
Your answer
Student email address *
Your answer
Student Mailing Address *
Your answer
Year of graduation *
School for fall of 2019 *
Marching band participation *
What is your first choice of instrument for marching band? *
Your answer
If you have a second choice of instrument for marching band, what is it?
Your answer
Are there are any medical or other concerns that we should be aware of as we teach your child in in marching band rehearsals? If there are- Mrs. Holmes or Mr. Shaw will be in touch to schedule a brief conference. *
Required
The High School Band is often in places where we could have newspaper or other media taking pictures or video. Do you give permission for pictures? *
History of head injury/concussion: Has the student ever had a traumatic head injury? *
History of head injury/concussion: If yes, when was head injury? (Please skip if none)
Your answer
History of head injury/concussion: Has the student ever received medical treatment for a head injury? *
History of head injury/concussion: If received treatment, when(month and year)?
Your answer
Please describe circumstances of this head injury
Your answer
History of head injury/concussion: Was the student diagnosed with a concussion?
Duration of Symptoms (such as headache, difficulty concentrating, fatigue) for the most recent concussion:
Your answer
Students and parents need to take the following concussion training. Please print the certificate and send it in to Mrs. Holmes when you have completed it. This must be done before band camp begins on August 12. http://www.cdc.gov/concussion/HeadsUp/Training/index.html This link is also available on the Marching Band Information handout *
Permission to participate: *
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