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West Briar Band Registration Form
Please complete a separate form for each student that you have in the West Briar MS Band Program. Thank you!
The information collected in this form will only be used to contact Parents and Students regarding activities related to the West Briar Middle School Band Program. Your information will not be shared with any other individuals, groups, or organizations. This online form was created in an effort to reduce the use of paper. Thank you! ~Mr. Hall
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* Indicates required question
STUDENT INFORMATION
What is the student's ID Number?
*
Your answer
What is the student's FIRST name?
*
Your answer
What is the student's LAST name?
*
Your answer
What grade is the student?
*
6
7
8
What is the Student's Date of Birth?
*
MM
/
DD
/
YYYY
What is the Student's Gender?
*
Female
Male
Prefer not to say
Other:
What is your student's EMAIL address? (optional)
Your answer
What is your student’s t-shirt size?
*
Choose
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult X-Large
Adult XX-Large
Adult XXX-Large
What is your student's primary instrument?
*
Choose
Flute
Oboe
Bassoon
Clarinet
Bass Clarinet
Alto Saxophone
Tenor Saxophone
Baritone Saxophone
Trumpet
French Horn
Trombone
Euphonium
Tuba
Percussion
Undecided
Which band is your student in?
*
Beginning Band (1st Period, 3rd Period, 6th Period, or 7th Period)
Symphonic Band & Percussion (Intermediate Band, 2nd Period)
Wind Ensemble (Advanced Band, 5th Period)
STUDENT'S HOME ADDRESS
Please provide the home mailing address.
Home Street Address?
*
Your answer
City?
*
Your answer
Zip Code?
*
Your answer
PARENT 1 INFORMATION
What is the Parent's FIRST name?
*
Your answer
What is the Parent's LAST name?
*
Your answer
What is the Parent's EMAIL address?
*
Your answer
What is the relationship to the student?
*
Father
Mother
Other:
What is the Parent's phone number (no dashes)?
*
Your answer
PARENT 2 INFORMATION
(OPTIONAL)
What is the 2nd Parent's FIRST name?
Your answer
What is the 2nd Parent's LAST name?
Your answer
What is the 2nd Parent's relationship to the student?
Mother
Father
Other:
Clear selection
What is the 2nd Parent's phone number (No Dashes)?
Your answer
What is the 2nd Parent's EMAIL address?
Your answer
Media Release for West Briar MS Bands
Do you grant permission for photos or videos of your student to appear on the West Briar Middle School Website and Social Media sites? The photos and videos will be used for educational and promotional purposes for the West Briar MS Band program. Student names will not be associated with the media.
*
Yes
No
PARENT VOLUNTEER INFORMATION
Are you interested in Chaperoning Field Trips for the Bands?
*
Yes
No
Maybe
Are you interested in assisting with Fundraising Activities?
*
Yes
No
Maybe
Do you have any specific skills, interests, or talents that could benefit the West Briar Middle School Band Program? (ex. fundraising experience, catering/cooking, professional musician, carpentry skills, etc.)
Your answer
Do you agree to the policies of the West Briar Middle School Bands in accordance with the West Briar MS Student Handbook? Please write your first and last name to sign this document. Thank you!
*
Your answer
Please contact Mr. Hall if you have any questions, concerns, or ideas. Thank you!
lhall8@houstonisd.org
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