OSYO Audition/Registration Form 2018
Musician First Name *
Your answer
Musician Last Name *
Your answer
Are you a returning OSYO Musician *
Street Address *
Your answer
City *
Your answer
Postal Code *
Your answer
Date of birth (select the month and day, then highlight and change the year) *
MM
/
DD
/
YYYY
Phone number (musician) *
Your answer
Email (musician) *
Your answer
Grade in September 2018 *
School
Your answer
Chosen Instrument *
Your answer
Years Studied *
Your answer
Playing Level (Specify RCM or Suzuki)
Your answer
Private Music Teacher First Name
Your answer
Private Music Teacher Last Name
Your answer
Private Music Teacher Email
Your answer
What other instruments do you play (and how long)?
Your answer
Parent Name (Main Contact) *
Your answer
Relationship to Musician *
Your answer
Best Phone # *
Your answer
Email *
Your answer
Occupation *
Your answer
Parent Name (Second Contact)
Your answer
Relationship to Musician
Your answer
Best Phone #
Your answer
Email
Your answer
Occupation
Your answer
Doctor's Name
Your answer
Doctor's Phone #
Your answer
Any Dietary Restrictions? *
Your answer
Allergies *
Please provide details on any allergies
Your answer
Please detail any other health concerns *
Your answer
Please advise any prescription medication the musician is currently taking *
Your answer
I consent to my child's photo/image/video being displayed publicly and online by OSYO (if musician is identified, it will be by first name only). *
In the event of an accident or other event, I authorize the OSYO to secure such medical services as may be deemed necessary. I agree to hold harmless OSYO staff and volunteers. I understand that every effort will be made to contact me if medical attention is sought. *
Please type your name to confirm consent *
Your answer
How did you hear about the OSYO? *
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