Registration Order Number Number of Members Registering OneTwoThree Contact Information Parent/Guardian Name * Home Phone * Cell Phone Main Email [parent] * Parent 2nd Email [optional] Student email Mailing Address City State - Select Province/State - Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon ==================== Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code Session * Fall Spring Additional Information Media Release Media Release * YES, Homer Youth String Orchestra Club may use photos and videos of my child, self and/or any other participating family member for promotional purposes which includes print, website and social media. NO, Homer Youth String Orchestra Club may NOT use photos and videos of my child, self and/or any other participating family member any promotional purposes. Your Name * Today's Date * Parent Volunteer Commitment Nothing assures a child's success in music more than the parents' sincere interest in their participation. Here are some ideas to help students succeed: Set aside a regular time and suitable place for your child to practice. Help your child to keep a daily record of practice. Make certain your child is on time for all performances, rehearsals and events. Email or call the conductor at regular intervals so you will understand your child's progress. Attend all concerts and show your enthusiasm. If not already, obtain private lessons with a qualified instructor. Orchestra class cannot and should not take the place of private instruction. After a performance, comment on how your student's performance affected you, rather than commenting on how many mistake you did or did not hear. Listen to music in the home. Take your student to a concert. Make music part of our daily routine. Also, your volunteer commitment is CRUCIAL to the success and opportunities we as a club can provide for our students. Parents are REQUIRED to volunteer their time and skills during the semester. In the past, parents have been very helpful in setting up/taking down and providing food for concerts, but WE NEED MORE HELP!! We are especially lacking aid in grant writing/business sponsorship follow up, photography, organizing fundraisers and fun social events for the kids. Coda member are encouraged to GET INVOLVED and help us foster the orchestral arts for our Homer area youth. Please select your area of interest/s and our Oversight Committee will be in touch. Volunteer * SPECIAL EVENTS: Concerts, other performances. GRANT WRITING/SPONSORSHIP: Maintain current grants and seek out new grants. Send progress reports to sponsors. FUNDRAISING: Organize Practice-A-Thon and other fundraising events. WEBSITE AND SOCIAL MEDIA: Public Communication. STUDENT FUN: Organize workshops, social events and celebrations. PHOTOGRAPHY: Photograph events. CODA MEMBER: Not sure, let me know how I can help. Hold Harmless, Release and Waiver of Liability To the maximum extent allowed by law, I agree to hold harmless the HomerOPUS and the Homer Youth String Orchestra (HYSOC) and their staff, directors and designees (hereafter “orchestra”) for expenses relating to injuries (up to and including death), accidents, diseases, property damage, and /or property loss which may occur as a result of the students participation in an Orchestra activity except to the extent such injuries are directly caused by the reckless or intentional actions of the Orchestra. HYSOC classes will follow the KPBSD symptom free school protocol. Please do not participate in classes if you are experiencing symptoms that could potentially be from a contagious disease process. Temperature of 100.4 or more degrees New cough or shortness of breath Chills and muscle aches that are not common to you Runny or stuffy nose with a sore throat Headache Vomiting Diarrhea Nausea or abdominal pain New loss of taste or smell New undiagnosed rash or within the first 24 hours of taking an antibiotic treatment BY SIGNING BELOW, I CERTIFY THAT I HAVE READ AND UNDERSTAND THIS WAIVER AND RELEASE; THAT I AM THE PARENT OR LEGAL GUARDIAN OF THE MINOR CHILD(REN) WHOM I ACCOMPANY OR ALLOW TO PARTICIPATE IN HYSOC; AND THAT I KNOWINGLY AGREE TO RELEASE AND WAIVE ANY CLAIM OR LEGAL CAUSE OF ACTION THAT I OR MY CHILDREN MAY HAVE AGAINST HYSOC. Your Name * Date *
