I have read and understand the Patapsco Middle School Performing Ensembles Guidebook. I plan to attend all extra rehearsals and all performances.

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Parent’s signature Student’s signature

I am participating in the following groups (please check all that apply):

_____ Band _____ Choir _____ Orchestra

Name as it should appear on programs:

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First Last

Phone Numbers:

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Home Work (please specify parent) Emergency

E-mail addresses you would like information sent to:

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Private Teacher’s Name:_______________________ Phone:_________________

Any medical concerns for rehearsals, concerts, field trips, etc.:

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Note - At times rehearsals and concerts will be recorded and/or video taped and used as an educational tool to help the students and the director . Additionally, regular TV and radio, public TV and radio, and Howard Co. cable TV have aired rehearsals and concerts of Howard County performing groups as a public service. If this is a concern please contact your child's director.

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Parent’s Name(s)

Parent Signature_______________________________ Date:__________________