CONTACT INFORMATION

BEFORE YOU BEGIN FILLING OUT THIS FORM: you may want to insure you have a copy of the health insurance card that provides coverage for your student, as you will neeed to upload an image during the registration process. Please also ensure your student is nearby, as you and your student will both need to sign the form before submitting.

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STUDENT First Name *

STUDENT Last Name *

STUDENT Birthdate * +

STUDENT Grade Level, Fall 2022 *

STUDENT Marching Instrument *

The GH Band Parents Association provides a t-shirt (known as the "Row Shirt") for each student, free of charge, which they will receive before Band Camp and use throughout the school year. Please select the size you believe will best fit your student for the 2022-23 school year.

STUDENT T-shirt Size (unisex sizing) *

STUDENT Street Address *

STUDENT Home Phone Number *

PARENT/GUARDIAN #1 First Name *

PARENT/GUARDIAN #1 Last Name *

PARENT/GUARDIAN #1 Cell Phone *

PARENT/GUARDIAN #1 Email Address *

PARENT/GUARDIAN #2 First Name

PARENT/GUARDIAN #2 Last Name

PARENT/GUARDIAN #2 Cell Phone

PARENT/GUARDIAN #2 Email Address

In case of emergency, if the above persons cannot be reached, please contact:

EMERGENCY CONTACT First Name *

EMERGENCY CONTACT Last Name *

EMERGENCY CONTACT RELATIONSHIP to Student *

EMERGENCY CONTACT Phone Number *