Band Registration 2022
Eugene Reimer Middle School
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First Name *
Last Name *
Gender *
Grade *
Name of Parents/Guardians *
Parent/Guardian Email Address *
Contact Phone number *
Emergency Contact Name *
Emergency Contact Phone number *
Any Health Concerns, Allergies, or Dietary Restrictions? *
T-shirt Size *
Band Uniform
Would you like to rent or purchase a band uniform shirt? *
Have you ever studied an instrument before? *
If so, which instrument and for how long?
e.g. piano, 3 years
Which Instrument are you MOST interested in learning? *
choose your first option
Which Instrument are you interested in learning? *
choose your second option
Which Instrument would you like to learn? *
choose your third option
Will you be renting an instrument for your child? *
Rentals range from $15-30 per month, depending on the instrument, and are highly recommended for the program.  Benefits of renting include a better quality instrument to play and the option to insure the instrument inexpensively protecting you from theft, damage, or loss.
By checking each box below, I have read all of the following rules and regulations and agree to follow them: *
Please check ALL boxes.
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