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NMHS Band - Registration
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* Indicates required question
Student Name
*
Your answer
Student ID Number
*
Your answer
Grade Level (2022-2023)
*
9
10
11
12
Primary Instrument
*
Your answer
Additional Instruments (if any)
Your answer
I wish to participate in which Marching Band ensemble:
*
Competition Marching Band
Football-Only Marching Band
I have a medical condition/concern and cannot participate in Marching Band at all - I will discuss an exemption with Mr. Janosa
Required
Date of Birth
*
MM
/
DD
/
YYYY
Student Cell Phone
*
Your answer
Student Email
*
Your answer
Additional Email
Your answer
Primary Parent/ Guardian Name
*
Your answer
Relationship to Student
*
Your answer
Cell Phone
*
Your answer
Home Phone
*
Your answer
Address
*
Your answer
Primary Email
*
Your answer
Additional Parent/Guardian
Your answer
Relationship to Student
Your answer
Cell Phone
Your answer
Home Phone
Your answer
Address
Your answer
Primary Email
Your answer
Additional Emergency Contact Name
Your answer
Relationship to Student
Your answer
Cell Phone
Your answer
Home Phone
Your answer
Address
Your answer
Primary Email
Your answer
Additional information that the Director should be aware of? (preferred names, medical concerns, additional contact info etc. All provided information will remain confidential)
Your answer
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