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Mid America Freedom Band
Membership Agreement and Emergency Contact Information
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Email
*
Your email
Name
*
Your answer
Birthday
*
MM
/
DD
/
YYYY
Occupation
*
Your answer
Employer
Your answer
Instrument
*
Your answer
Street Address
*
Your answer
Apartment Number
Your answer
City
*
Your answer
State
*
Your answer
ZIP Code
*
Your answer
Primary Phone
*
Your answer
Secondary Phone
Your answer
Emergency Contact
*
Your answer
Emergency Contact Phone
*
Your answer
Please check ensembles you are interested in/are performing in.
*
Mid America Freedom Band (Concert Band)
Mighty Mo Combo (Jazz Band)
Spirit Pep Band (Pep/Marching Band)
Required
If participating in concert band, please check the concerts that you plan to perform in.
*
Fall
Holiday
Winter
Spring
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