2019-2020 Form for Parents and Guardians
This form is mandatory for all parents of Solon High School Music students in order for your student to participate in activities associated with the music program. The information requested in this form covers Medical Information, Emergency Medical Authorization, Authorization for Non-prescription Medication or Treatment, the Bus Transportation Release and the Uniform Contract. Please read the following information carefully before filling out the form.

MEDICAL EMERGENCY AUTHORIZATION: The purpose of collecting this information is to make it possible for parents and/or guardians to authorize the provision of emergency treatment for students who become ill or injured while under group authority when parents and/or guardians cannot be reached for the purpose of giving consent for such treatment. Such authority is necessary to overcome legal obstacles to the provision of such treatment when all reasonable attempts to reach parents and/or guardians have failed. We must have this authorization for Solon Band Camp activities.

MEDICAL INFORMATION: The information collected is needed by any hospital or practitioner not having access to the student's medical history

AUTHORIZATION FOR NON-PRESCRIPTION MEDICATION OR TREATMENT: This agreements applies to students who attend Solon High School.
Authorization for Staff - Only Licensed health professionals accompanying the students are authorized to administer medications.

BUS TRANSPORTATION RELEASE FORM: The student named is allowed to travel with the Solon High School Band for the 2019-2020 school year. Bus transportation will be provided by the Solon Board of Education.

UNIFORM CONTRACT: The agreement between the student and parents with the Solon Music Parents organization to ensure proper treatment of the uniforms and outline replacement costs for lost or damaged components of the uniform issued to students. Replacement costs are as follows:
Coat - $215
Pants - $110
Hat - $50
Capes - $60
Raincoats - $54
Beret (tubas) - $15
Gloves - $2
Braids - $2 - $12
Hat Box - $6

Additionally, student agrees to -
1) Have shoes as specified by the directors. Shoes will be purchased prior to band camp.
2) Safeguard the uniform issued to them and avoid behavior that would stain or damage it.
3) Reimburse the Solon Music Parents organization for uniform items lost or damaged.
4) Appropriate dress for underneath the uniform is sport shorts (nylon or cotton), an acceptable t-shirt, and appropriate height white socks for marching band. This clothing is furnished by the student and remains their property.

Student Information
t
Student ID *
This must be correct. Please verify the number with your student before submitting this form
Your answer
Student last name *
Your answer
Student first name *
Your answer
Student middle name *
Your answer
If your student goes by an alternate first name, please indicate that alternate name here
Your answer
Gender *
Grade for 2019 - 2020 school year *
Instrument student will play in the Marching Band *
Use Starlette when appropriate
Your answer
Date of birth in MM/DD/YYYY format *
MM
/
DD
/
YYYY
Student contact number - cell phone (preferred) or home phone number *
Your answer
Student email address *
Your answer
Student's full home address - include house/apt. #, street, city, state and zip code *
Your answer
Parent/Guardian Information
Please complete this information for applicable parents and/or guardians. ***IMPORTANT***: Take extra care to be consistent in your responses throughout the ENTIRE form for who you designate as Parent #1/Guardian #1 and who you designate as Parent #2/Guardian #2. Enter N/A when necessary
Parent #1 or Guardian #1's last name *
Please take extra care to be consistent in your responses throughout the ENTIRE form for who you designate as Parent #1/Guardian #1 and who you designate as Parent #2/Guardian #2.
Your answer
Parent #1 or Guardian #1's first name *
Your answer
Gender of Parent #1 or Guardian #1 *
Parent #1 or Guardian #1's full home address (house/apt. #, street, city, state, zip code) *
If same as the student's, you may entered the word "same"
Your answer
Parent #1 or Guardian #1's home phone *
Your answer
Parent #1 or Guardian #1's work phone number *
Your answer
Parent #1 or Guardian #1's cell phone number *
Your answer
Parent #1 or Guardian #1's email address *
Your answer
Parent #2 or Guardian #2's last name *
Please take extra care to be consistent in your responses throughout the ENTIRE form for who you designate as Parent #1/Guardian #1 and who you designate as Parent #2/Guardian #2.
Your answer
Parent #2 or Guardian #2's first name *
Your answer
Gender of Parent #2 or Guardian #2 *
Parent #2 or Guardian #2's full home address (house/apt. #, street, city, state, zip code) *
If the same as the student's, you may enter the word "same"
Your answer
Parent #2 or Guardian #2's home phone number *
Your answer
Parent #2 or Guardian #2's work phone number *
Your answer
Parent #2 or Guardian #2's cell phone number *
Your answer
Parent #2 or Guardian #2's email address *
Your answer
Emergency & Medical Information
Name of insurance company *
Emergency Medical Authorization form
Your answer
Policy number *
Emergency Medical Authorization form
Your answer
Name of person (first and last) to contact if unable to reach a parent/guardian (emergency contact) *
Emergency Medical Authorization form
Your answer
Relationship of this emergency contact to the student *
Emergency Medical Authorization form
Your answer
Full address of the emergency contact (street, city, state and zip) *
Emergency Medical Authorization form
Your answer
Home phone number of emergency contact *
Emergency Medical Authorization form
Your answer
Work or cell phone number of emergency contact *
Emergency Medical Authorization form
Your answer
I give consent for emergency medical treatments to be provisioned as indicated at beginning of this form *
Emergency Medical Authorization form
Student Dietary Restrictions *
Medical Information form - Type N/A if none
Your answer
Is student vegetarian or vegan (if so, specify which)? *
Medical Information form - Type N/A if none
Your answer
Student Allergies *
Medical Information form - Type N/A if none
Your answer
Please indicate any physical impairments for this student below *
Medical Information form - Type N/A if none
Your answer
Student Chronic conditions *
Medical Information form - Type N/A if none
Your answer
Medical diagnosis for all the following medication (i.e. asthma, etc.) *
Medical Information form - Type N/A if none
Your answer
List all medication needed. Include the name of the medicine, dosage and time of day needed *
Medical Information form - Type N/A if none
Your answer
How is the medicine listed above to be administered *
Medical Information form
Family physician *
Medical Information form
Your answer
Physician phone number *
Medical Information form
Your answer
Preferred hospital *
Medical Information form
Your answer
Family dentist *
Medical Information form
Your answer
Dentist phone number *
Medical Information form
Your answer
I hereby give my consent; that in the event that all reasonable attempts that have been made to contact me at my home or place of employment have been unsuccessful, for the administration of any treatment deemed necessary by any hospital reasonably accessible. This authorization does not cover major surgery unless the medical opinions of two other licensed physicians or dentists, concurring in the necessity of such surgery are obtained prior to the performance of such surgery. *
Medical Information form
I am requesting permission for my child named within this form to use or receive the following over the counter medications (list all by name and the dosage authorized, for example ibuprofen 200 mg every 4 - 6 hours) *
Non-prescription medication form
Your answer
How are these medications to be administered? *
Non-prescription medication form
I will assume responsibility for safe delivery of the medication to school or school related activity *
Non-prescription medication form
I will notify the school immediately if there is any change in the use of the medication or prescribed treatment *
Non-prescription medication form
I release and agree to hold the Board of Education, its officials, and its employees harmless from any and all liability foreseeable or unforeseeable for damages or injury resulting directly or indirectly from this authorization for non-prescription medications *
Non-prescription medication form
I give consent for non-prescription medications to be administered as indicated above. *
Non-prescription medication form
I give consent for my child to travel with the Solon High School Band for the 2019 - 2020 school year *
Transportation form
I agree to the Uniform Contract terms as outlined above: *
Uniform contract
I understand that Band Camp is a school sponsored activity and that the Solon High School Code of Conduct and the Solon Board of Education school discipline policies apply to Band Camp, Band activities, and during transport for Band activities. *
Code of Conduct compliance
I understand that directors, staff, chaperones, and bus drivers are to be treated with respect and that my student shall comply with directives and reasonable requests of directors, staff, chaperones, and bus drivers at all times. *
Code of Conduct compliance
My student and I have read the Band Camp Information packet, including the Camp Rules. *
Code of Conduct Compliance
Full name of parent or guardian completing this form *
This serves as your electronic signature for the responses in this form. Date and time completed will be collected automatically upon submission.
Your answer
Band Camp Payment Information
You will be able to pay for Band Camp via check, debit card, or credit card. If you pay by check, it must be made out to "Solon Music Parents" *
How do you intend to pay for Band Camp? *
Volunteer Opportunities for Parent #1 or Guardian #1
Please take extra care to be consistent in your responses throughout the ENTIRE form for who you designate as Parent #1/Guardian #1 and who you designate as Parent #2/Guardian #2.
What committees/events would you like to help with? (Parent #1 or Guardian #1) *
Parent #1 or Guardian #1, what committees and events can you help with? Choose as many as you want! Please note: Every family is expected to assist with at least one of these events in addition to volunteering at least once for Concessions.
Required
If you would like to chair any of the above events or be involved in the planning committee for any of these events, please indicate which event(s) here:
Your answer
When are you best able to work at a concessions stand? (Parent #1 or Guardian #1) *
Parent #1 or Guardian #1, every family (parents, students, or both) is expected to volunteer at least once during the year for concessions. Please tell us when the best time is for you to help out. You can make multiple selections.
Required
Volunteer Opportunities for Parent #2 or Guardian #2
Please take extra care to be consistent in your responses throughout the ENTIRE form for who you designate as Parent #1/Guardian #1 and who you designate as Parent #2/Guardian #2.
What committees/events would you like to help with? (Parent #2 or Guardian #2) *
Parent #2 or Guardian #2, what committees and events can you help with? Choose as many as you want! Please note: Every family is expected to assist with at least one of these events in addition to volunteering at least once for Concessions.
Required
If you would like to chair any of the above events or be involved in the planning committee for any of these events, please indicate which event(s) here:
Your answer
When are you best able to work at a concessions stand? (Parent #2 or Guardian #2) *
Parent #2 or Guardian #2, every family (parents, students, or both) is expected to volunteer at least once during the year for concessions. Please tell us when the best time is for you to help out. You can make multiple selections.
Required
Our family has a talent or business that may be helpful to Solon Music Parents
If someone in your family has a skill or business that may be able to assist Solon Music Parents, please describe it below.
Your answer
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