Pipe Band Registration Form
This is a Registration Form the for the Transcona & District Pipe Band. Please complete all information on it so we can have it on record. Next year we will save your responses and you will not have to re-enter the information. Thank you!
Name of Band Member *
Your answer
Instrument *
Instrument Level (Beginner or Grade Level) *
Your answer
Birth Date *
MM
/
DD
/
YYYY
Student Email Address
Your answer
Student Cell No.
Your answer
Student Address incl Postal Code *
Your answer
Name of Parents/Guardians *
Your answer
Address of Parents/Guardians (if different)
Your answer
Parent 1 Phone Number *
Your answer
Parent 1 Email Address *
Your answer
Parent 2 Phone Number
Your answer
Parent 2 Email Address
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Phone Number *
Your answer
Relationship to Band Member *
Your answer
Photography Consent
Our Pipe Band would like to share information and communication with parents/guardians/public by highlighting the Pipe Band’s activities and achievements in a variety of publications and/or flyers.
*
Media Consent
Many positive things take place within the Transcona & District Pipe Band and we would like to share this good news with the broader community by posting photographs and write ups on social media such as Facebook, Twitter, etcetera & by inviting journalists and other members of the media to visit our Pipe Band. Posting of photographs, videotaping or interviews are only allowed with permission from a Pipe Band Board Member. All pictures and media published are owned by the band and may be used in future publications.
*
Member Agreement
By entering my name under this Agreement I understand the responsibilities, conduct and commitments as set down by the instructors and association. If you require details about these please consult the Transcona & District Pipe Band web site at www.transconapipeband.org
Agreed by: *
Your answer
Date *
MM
/
DD
/
YYYY
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service