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BRAVO 2021 Registration Form
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* Indicates required question
Student First Name
*
Your answer
Student Last Name
*
Your answer
Parent/Guardian Name
*
Your answer
Street Address
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
Parent Cell Phone
*
Your answer
Home Phone
Your answer
Parent Email
*
Your answer
Student Date of Birth
*
MM
/
DD
/
YYYY
Student Grade Level
*
5th
6th
Other:
Current School
*
Adams Elementary
Cleveland Elementary
Franklin Elementary
Harding University Partnership
McKinley Elementary
Monroe Elementary
Roosevelt Elementary
Santa Barbara Community Academy
Washington Elementary
Other:
What ethnicity best describes the student? (For statistical purposes ONLY)
*
Mexican, Mexican American, Chicano
Puerto Rican
Cuban
Other Hispanic, Latino, or Spanish origin-- for example: Argentinian, Colombian, Dominican, Nicaraguan, Salvadoran, Spaniard, et cetera.
White
Black or African American
American Indian or Alaska Native
Asian Indian
Chinese
Filipino
Other Asian-- for example: Hmong, Laotian, Thai, Pakistani, Cambodian, et cetera.
Japanese
Korean
Vietnamese
Native Hawaiian
Guamanian or Chamorro
Samoan
Other Pacific Islander-- for example: Fijian, Tongan, et cetera.
Other:
What Instrument will your child play in BRAVO?
*
Flute
Clarinet
Saxophone
Trumpet
Trombone
Violin
Viola
Cello
String Bass
Euphonium
Does your student have any allergies or medical needs we should be aware of?
Your answer
Emergency Contact #1, NAME
*
Your answer
Emergency Contact #1, PHONE
*
Your answer
Emergency Contact #2, NAME
Your answer
Emergency Contact #2, PHONE
Your answer
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