Island Ukuleles Registration 2022/2023
September 2022 - June 2023 Registration
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Student Name (1) *
First and last name please
What Group Is Your Student Registering For? (1) *
A Group (Auditioned 6 - 12), Junior A Group (Gold pin group), B Group (grade 4 - 8)
What Grade Is Your Student In For The 2022/23 School Year? (1) *
What School Does Your Student Attend? (1) *
School District (1) *
Please indicate the district number of your school
Medical Alert Information
Please indicate any allergies, medications, or existing medical conditions that we should be aware of? *
Enter "N/A" in none exist
Additional Family Registration
Island Ukuleles is very proudly a family based program and we encourage all eligible students in a family to be a part.  If you have more than one student, please enter their information here.  Family rates are applicable (for full year only), please discuss with our secretary or treasurer.
Student Name (2)
First and last name please
What Group Is Your Student Registering For? (2)
A Group (Auditioned 6 - 12), Junior A Group (Gold pin group), B Group (grade 4 - 8)
Clear selection
What Grade Is Your Student In For The 2022/23 School Year? (2)
Clear selection
What School Does Your Student Attend? (2)
School District (2)
Please indicate the district number of your school
Clear selection
Medical Alert Information
For Student 2
Please indicate any allergies, medications, or existing medical conditions that we should be aware of?
Enter "N/A" in none exist
Additional Family Registration
Island Ukuleles is very proudly a family based program and we encourage all eligible students in a family to be a part.  If you have more than one student, please enter their information here.  Family rates are applicable (for full year only), please discuss with our secretary or treasurer.
Student Name (3)
First and last name please
What Group Is Your Student Registering For? (3)
A Group (Auditioned 6 - 12), Junior A Group (Gold pin group), B Group (grade 4 - 8)
Clear selection
What Grade Is Your Student In For The 2022/23 School Year? (3)
Clear selection
What School Does Your Student Attend? (3)
School District (3)
Please indicate the district number of your school
Clear selection
Medical Alert Information
For Student 3
Please indicate any allergies, medications, or existing medical conditions that we should be aware of?
Enter "N/A" in none exist
Primary Contact Information
Please provide primary contact information for your student(s).
Address *
Number and Street
City *
Province *
Postal Code *
Home Phone (Or Best Available) *
XXX-XXX-XXXX
Email Address *
Mother's Name
(If Applicable)
Father's Name
(If Applicable)
Additional Contact Information
Any additional contact information that we may need should be entered here:
Additional Phone Number
Please indicate number and owner
Additional Email Address
Please indicate address and owner
Additional Address Information
If your student lives at multiple households, please indicate any other addresses and who is the primary contact there.  Postal codes are required.
I/We are willing to assist in the following area(s):
Check all areas that apply
Other, (please describe)
Registration Fees
Registration Fees *
Our treasurer will reach out to arrange payment.  Fees subject to annual review.
Required
Island Ukuleles A Music Society Membership Application
Please indicate if you wish to apply for or renew your membership to the Island Ukuleles A Music Society.  Please note, a signature will be required to officially join.
I/We ______________________ wish to renew/apply for membership in the Island Ukuleles A Music Society.  I acknowledge that membership requires adherence to the Society's Constitution and By-laws and a payment of an annual registration fee of $1 each.
Please enter parent name(s)
Society Fees
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**No student will be denied the opportunity to participate because of an inability to pay.  Please contact Tina Horwood (Musical Director) if finances are a concern.  Your confidentiality will be respected.**
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