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Trenton Music Makers Registration Form
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Email
*
Your email
Student Name
Your answer
Parent 1 Name
Your answer
Parent 2 Name
Your answer
Home Address
Your answer
Parent 1 Cell Phone
Your answer
Parent 2 Cell Phone
Your answer
Emergency Contact #1 - name and number
Your answer
Emergency Contact #2 - name and number
Your answer
Emergency Contact #3 - name and number
Your answer
Student's School
Your answer
Students Grade 2019-20
Your answer
For middle and high school students: will your student attend program on optional Wednesdays, in addition to the required Mondays, Tuesdays and Thursdays?
Yes
No
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Transportation will be provided from school to the program site at Union Baptist Church, 301 Pennington Avenue, Trenton. Please indicate how your child will be dismissed at the end of the program day:
I will pick up my child at Union Baptist Church.
My child has my permission to leave when dismissed. (Note: available for grades 6-12 ONLY.)
I am not able to pick up my child from Union Baptist Church. Please contact me to discuss transportation home.
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Does your child have an IEP or 504 Plan, and would you be willing to share any information that helps us to meet your child’s needs?
Your answer
Does your child have any food allergies?
Your answer
Parents, please indicate your agreement in the boxes below:
My child has my permission to participate in the Trenton Music Makers Orchestra program, and to ride the bus from school to Union Baptist Church on program days.
I agree that Trenton Music Makers may transport my child by car in case of emergency.
I have received a copy of the Trenton Music Makers Handbook, and my child and I agree to comply with the Code of Conduct, the Attendance Policy, and the Parental Pickup Policy.
I grant permission for Trenton Music Makers to utilize pictures and video recordings of my child, and recordings made of his/her voice or music, for possible print, video or audio media, or digital publication.
I agree that the Trenton Public Schools may release to Trenton Music Makers my child’s attendance data, for the current year and any years prior to 2019-20.
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