Spring 2012 Registration - Due 1/6/2012
This form is required to register your students for JUHSB band classes that will occur during Spring 2012. Please note, this form must be filled out every semester! This is the only way I know who will be attending classes, and which classes they will attend. Failure to fill this out each semester will result in your child not being enrolled in classes.

Please consider all entries "required" except the student's cell phone and email address. However, this is helpful information for me to have. I encourage students to contact me if they have questions or need help with their assignments or practicing. Having their information in my address book ensures that I recognize the call/email as coming from them so that I can treat it as a priority.

There are designated spaces for 5 students. Please take note of the (1), (2), (3), (4), and (5) before each line to know which student it is referring to. I suggest going in age order to help you keep track of it until you get used to the format. If you have more than 5 students who will be enrolled in classes this semester, please contact me and we will figure out how to handle your registration. Also, please note that the total maximum family tuition amount is $600 per semester, regardless of the number of students enrolled. Contact me for more info if this applies to you! If you have less than 5 students enrolling this semester, then simply start at Student (1) and use only how many you need.

This is our first time using Google Docs for registration. The format is far from perfect. It will improve as I learn more about using it, so please be patient during our attempts at progress. If you are unsure of what to do, please feel free to contact me and I will do my best to help you!

Schedule (will also be emailed as a reminder, and posted on our website as soon as possible):
1/9-13/2012 Classes begin. Bremen classes are on Mondays. Ashland classes are on Tuesdays. Newnan classes are still to be determined, but will be on either Wednesday mornings, Thursdays, or Fridays.
3/26-30/2012 Spring Break. This corresponds with FACS Spring Break, as part of my schedule is dictated by their schedule. If your family will be gone another wee for Spring Break, please let me know in advance so that your children do not fall behind while you are gone.
5/7-11/2012 Last week of classes. Concerts will be scheduled for this week. These dates are still to be determined, but we will be discussing it within the first few weeks of classes.
*Some of you know that I normally take a week off in February to go to District Honor Band. I had no students audition for District Honor Band this year, therefore my presence is not required and I will not be going. We WILL have classes that week.

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Custodial Parents' Names *
Please fill out all inforation for the parent(s) that the child(ren) lives with. This information will be used for correspondence between teacher and parent(s), as well as in cases of emergency.
Custodial Parents' Address *
Please include City, State, and Zip Code
Home Phone *
If you do not have a home phone, please enter N/A.
Cell for mom/custodial stepmom listed above *
If you do not have a cell phone, please enter N/A.
Cell for dad/custodial stepdad listed above *
If you do not have a cell phone, please enter N/A.
Primary Email Address *
This email address will be used to relay information about your students' classes on a regular basis.
Secondary Email Address
If your spouse has an email that should be included, please enter that here. Please do not enter student emails here.
Emergency Contact *
Please enter the name and phone numbers of an emergency contact (which can be a non-custodial parent) who can be reached if your child is sick or injured and I am unable to reach the custodial parents. Please include their relationship in the family, to help me identify them to your child if needed.
Class Location *
(1) Student's Full Name *
(1) Student's DOB *
(1) Student's Grade Level *
(1) Student's Cell Phone
While not required, this is helpful information for me to have.
(1) Student's Email Address
While not required, this is helpful information for me to have.
(1) New Student Registration Fee *
If your student has never been enrolled in JUHSB band classes before, a $25 per student registration fee applies to assist with costs that occur only the first time the student is enrolled in our band classes. Exception - students who are only enrolled in Music Theory and no other classes are exempt from this fee.
(1) Student's Band Class(es) *
Please select the class(es) in which you are enrolling this student.
Required
(1) Student's Instrument *
If your student is in Beginning, Intermediate, or Advanced Band, please select the instrument that your child will be playing. This is important so that I have the correct music and books ready for your student. Does not apply to Rhythm Band and Recorder Band.
(2) Student's Full Name
(2) Student's DOB
(2) Student's Grade Level
(2) Student's Cell Phone
While not required, this is helpful information for me to have.
(2) Student's Email Address
While not required, this is helpful information for me to have.
(2) New Student Registration Fee
If your student has never been enrolled in JUHSB band classes before, a $25 per student registration fee applies to assist with costs that occur only the first time the student is enrolled in our band classes. Exception - students who are only enrolled in Music Theory and no other classes are exempt from this fee.
(2) Student's Band Class(es)
Please select the class(es) in which you are enrolling this student.
(2) Student's Instrument
If your student is in Beginning, Intermediate, or Advanced Band, please select the instrument that your child will be playing. This is important so that I have the correct music and books ready for your student. Does not apply to Rhythm Band and Recorder Band.
(3) Student's Full Name
(3) Student's DOB
(3) Student's Grade Level
(3) Student's Cell Phone
While not required, this is helpful information for me to have.
(3) Student's Email Address
While not required, this is helpful information for me to have.
(3) New Student Registration Fee
If your student has never been enrolled in JUHSB band classes before, a $25 per student registration fee applies to assist with costs that occur only the first time the student is enrolled in our band classes. Exception - students who are only enrolled in Music Theory and no other classes are exempt from this fee.
(3) Student's Band Class(es)
Please select the class(es) in which you are enrolling this student.
(3) Student's Instrument
If your student is in Beginning, Intermediate, or Advanced Band, please select the instrument that your child will be playing. This is important so that I have the correct music and books ready for your student. Does not apply to Rhythm Band and Recorder Band.
(4) Student's Full Name
(4) Student's DOB
(4) Student's Grade Level
(4) Student's Cell Phone
While not required, this is helpful information for me to have.
(4) Student's Email Address
While not required, this is helpful information for me to have.
(4) New Student Registration Fee
If your student has never been enrolled in JUHSB band classes before, a $25 per student registration fee applies to assist with costs that occur only the first time the student is enrolled in our band classes. Exception - students who are only enrolled in Music Theory and no other classes are exempt from this fee.
(4) Student's Band Class(es)
Please select the class(es) in which you are enrolling this student.
(4) Student's Instrument
If your student is in Beginning, Intermediate, or Advanced Band, please select the instrument that your child will be playing. This is important so that I have the correct music and books ready for your student. Does not apply to Rhythm Band and Recorder Band.
(5) Student's Full Name
(5) Student's DOB
(5) Student's Grade Level
(5) Student's Cell Phone
While not required, this is helpful information for me to have.
(5) Student's Email Address
While not required, this is helpful information for me to have.
(5) New Student Registration Fee
If your student has never been enrolled in JUHSB band classes before, a $25 per student registration fee applies to assist with costs that occur only the first time the student is enrolled in our band classes. Exception - students who are only enrolled in Music Theory and no other classes are exempt from this fee.
(5) Student's Band Class(es)
Please select the class(es) in which you are enrolling this student.
(5) Student's Instrument
If your student is in Beginning, Intermediate, or Advanced Band, please select the instrument that your child will be playing. This is important so that I have the correct music and books ready for your student. Does not apply to Rhythm Band and Recorder Band.
Agreement *
The following items are all required in order to participate in our band program. Once you have read each statement, please check the box next to it to confirm that you have read it and agree to it. All checkboxes must be checked before submitting.
Required
Release of Liability & Permission for Medical Treatment *
This is required by the locations in which we rehearse and hold performances. Also, it allows me to acquire medical attention for your child if an emergency should occur in you absence. While I have never had to use this in our band program, I have been in multiple situations in public school bands where permission for medical treatment was necessary. All checkboxes must be checked before submitting.
Required
Medical Information *
Please list below any medical conditions that your child(ren) has, any medications they take, any allergies (including food allergies) that they have, or any other information about your child(ren) that I would need to know if something happened in your absence. Please very clearly designate by name which child the information concerns. If this does not apply to any of your children, please type "does not apply" in the box below.
Electronic Signature *
Typing your name below serves as your electronic signature, signifying your agreement and commitment.
Relationship to the student(s) *
Please indicate your relationship to the student(s) on this form.
Submit
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