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Loara Band Registration 2021-2022
Welcome to the Loara Band! Tell us a few things about yourself.
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* Indicates required question
Email
*
Your email
Last Name
*
Your answer
First Name
*
Your answer
Student ID
*
Your answer
Grade
*
9
10
11
12
Preferred Pronoun
he/him
she/her
they/them
Other:
Date of Birth
*
MM
/
DD
/
YYYY
What Section of the Band Family are you a part of?
*
Flute
Oboe
Clarinet
Saxophone
Bassoon
Trumpet
Horn
Trombone/Euphonium
Tuba
Percussion
Color Guard
NON AUHSD EMAIL
*
Your answer
Address (Number, Street, City, Zip)
*
Your answer
Phone Number (Student Cell if you have one)
*
Your answer
Parent Name 1
*
Your answer
Parent Name 2
Your answer
Parent Phone 1
*
Your answer
Parent Phone 2
Your answer
Parent Email 1
*
Your answer
Parent Email 2
Your answer
Medical Insurance Provider (if none write "District")
*
Your answer
Medical Insurance Policy Number (If none write "District")
*
Your answer
Please list any known Allergies or write "none"
*
Your answer
Please list any medications your student takes that we would need to be aware of
*
Your answer
Please list the name and number of an emergency contact
*
Your answer
A copy of your responses will be emailed to the address you provided.
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