Huntsville Youth Orchestra

Tennessee Valley Music Festival 2014 Registration Form

Student Information:

Student: ______Instrument______Number of years played______

Date of Birth: ______Grade: ______Siblings participating in HYO: ______

Address: ______City, State, Zip: ______Home phone______

School: ______School System:______Private Teacher and / or band director: ______

Student Cell: ______Student Email: ______

Parent Guardian Information:

Preferred Email: ______Preferred Phone: ______

Parent/Guardian #1 Name: ______Daytime Phone: ______

Address (if different): ______City, State, Zip: ______Cell: ______

Employer: ______Work Phone: ______

Parent/Guardian #2 Name: ______Daytime Phone: ______

Address (if different): ______City, State, Zip: ______Cell: ______

Employer: ______Work Phone: ______

HYO Medical Release and Information:

In the event that I am unable to be reached, I hereby authorize medical or surgical treatment of illness or accidental injury for my child. I accept all responsibility for all occurrences during HYO events.

Parent/Guardian Signature: ______Date: ______

Insurance Company: ______Policy Number: ______Sponsor Name______

Doctor: ______Phone: ______Emergency Contact and phone number: ______

Are there any medical conditions we should be aware of? Medications? If so, please describe:

______

Conduct: It is the expectation of the Huntsville Youth Orchestra that all students participating in the orchestra conduct themselves appropriately during the year. Students are expected to follow guidelines set forth by the HYO Staff and the handbook. Participants are expected to treat our facility and its contents with the utmost care.

Any student who is observed abusing or defacing any property will be asked to leave the rehearsal. There will be no refund of tuition in the event a student is expelled due to inappropriate behavior.

Any type of illegal drug use to include, but not limited to, the smoking of cigarettes will lead to expulsion.

Students will respect each other and staff at all times.

Student Signature and Date: ______

Parent Signature and Date: ______

Student Name: ______

Payments and Other Information

Orchestra Fees

____Session I (Nimble Fingers, Nimble Minds)$95 ($105 if registered after May 18)

____Session II (Prelude and Redstone Orchestras)$190 ($205) if registered after May 18)

____Adult Chamber Orchestra$90 ($105) if registered after May 18)

____Session III $270 ($285) if registered after May 18)

(Tennessee Valley Philharmonic and Twickenham Symphony)

For Session III only! Please mark your top three preferences in the following classes in order of preference.

____Conducting _____Composition _____Jazz Band( Instrument, if different) ______

_____Music Theory ____Oboe Reed Making ____Acapella Vocals

Calculate Your Payment

Orchestra Fee………………………………………………………………….. $______

Donation to TVMF Scholarship Fund………………………………$______

Multiple Child Discount (subtract $20.00 for each additional child) $______

(Discounts per additional child are available to families with more than one child attending camp.)

Returning Student Discount (There is a $10 discount for students who played $______

with HYO during the 2013-14 season or attended TVMF 2013, and who register by May 18 .)

TOTAL………………………………………………………………………..…….$______

Credit Card Convenience Fee (Only if using a credit card for payment)…………………$15.00

GRAND TOTAL …………………………………………………………………………….$ ______

Amount Paid: ______May be mailed to: HYO / P.O.Box 2532 / Huntsville, AL 35804

Check # : ______More information at 256-880-0622 or

Received by: ______

Note: Refunds are given only for extreme circumstances. $50 of fee is a non-refundable registration fee.

Other Information and Permissions

Please mark size(s)- for student and for optional extra shirt(s)

__Youth M __Youth L __Adult S __Adult M __Adult L __Adult XL

Publicity Release: I give permission for any photos or videos of my student, ______, taken at rehearsals or concerts to be used for publicity purposes for HYO or TVMF events.

Parent/Guardian: ______Date: ______

Ethnic Group: For Grant writing purposes, please check one.

__White ___African Amer. ___Asian ___Native Amer. ___Hispanic ___ Other