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HSSYO REGISTRATION FORM
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* Indicates required question
EMAIL
*
Your answer
PARTICIPANT NAME
*
Your answer
GRADE LEVEL
*
Your answer
SCHOOL
*
Your answer
SCHOOL PRINCIPAL NAME
*
Your answer
Do you play a string instrument?
*
Yes
No
If yes, are you presently in your school orchestra program?
Yes
No
Clear selection
If yes, what is the instrument that you are currently playing?
Violin
Viola
Cello
Bass
Clear selection
Years of experience playing your instrument.
*
1st year
2nd year
3rd year
Intermediate
Advanced
Do you own your one instrument?
*
Yes
No
If you are a beginning string student, choose the instrument that you would like to play.
Violin
Viola
Cello
Bass
Clear selection
Are you interested in participating in Piano Class?
*
Yes
No
Years of experience playing the piano
*
1st year
2nd year
3rd year
Intermediate
Advanced
T- Shirt Size
*
Child Small
Child Medium
Child Large
Child X-Large
Adult Medium
Adult Large
Adult X-Large
Adult- 2X Large
Parent/Guardian Name
Your answer
Address
*
Your answer
Zip Code
*
Your answer
Home Phone Number
*
Your answer
Mobile Phone Number
*
Your answer
Email Address
*
Your answer
Name of emergency contact in the event a parent/guardian cannot reached.
*
Your answer
Emergency Contact Phone Number
*
Your answer
Emergency Contact Relationship to Participant
*
Your answer
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