Home | Contact  | About  | History | FAQ | Alumni | Donate | Maps

 

CHBA NEWSLETTER  |  REHEARSALS  |  MEMBER RESOURCES 

 

 JOIN HERE

MEMBER REGISTRATION FORM

Please complete this form once you are a member.

The information will be used for our permanent student records and is very helpful for us to have.

TODAY'S DATE:

00/00/0000

 

Please Choose One of the Three Programs Student is joining CHBA for:

Year Round Program (Fall, Spring, and Summer)

        Beginning Band

        Intermediate Band

        Advanced Band

        Symphonic Band

        Symphony Winds

Summer Program (This includes camp and summer time rehearsals and concerts)

        Centennial Beg/Intermediate  4:00-5:30 p.m.  Wednesdays

        Grant Ave. Beg/Intermediate  5:00-6:30 p.m.  Mondays

        Grant Ave. Summer Winds (Advanced) 6:30-8:30 p.m.  Mondays

 

Summer Camp Only, June 8-12, 2008 (This is only for camp, I'm not interested in becoming a full-time member)

 

 Please Choose Program and Check Number/Date:

Summer Band Only  $120.00

Summer Band + Camp  $455.00

Camp Only  $350.00 - Due May 5

 

Check        Check #    Date:

 

Please Choose Shirt Size for Summer Program:

 Polo shirt order (men's sizing)

Small    Medium   Large     Extra Large     XXL

 

Note: No need to order uniform for Fall/Spring Concert.

        Men: White dress shirt, black dress pants, black socks, black shoes.

        Woman: Black dress or black skirt or pants with white blouse and black dress shoes.

 

STUDENT INFORMATION

Student Name (First & Last):     

Home Phone:

Student Address:  

City    Zip 

Birth Date:      Grade:   School Name:
00/00/0000 

Instrument:

 

Student's Email:

 

 

FAMILY INFORMATION

Siblings currently in CHBA? Please list: 

 

Father's First and Last Name

Father's Occupation:  
     Place of employment:    Business Phone:
     Does the father play an instrument? YesNo     If so what?: 
 

Mother's First and Last Name:  
      Place of employment:    Business Phone:
     Does the mother play an instrument? YesNo     If so what?: 

BILLING INFORMATION

 

Parent responsible for billing: First and Last Name 

Other person responsible if applicable: First and Last Name

 

What is your billing address (if different from student's address above)?

Billing Address:  

City    Zip 


Home Phone:    Business Phone: 

 

Family Email:

 

 

EMERGENCY INFORMATION

Does the student have food allergies or chronic problems that we should know about? Please list:

 

 

If parent cannot be reached, please call the following people:

 First Alternative Contact

First and Last Name:    

Relationship to student:  

Phone: 

 

 Second Alternative Contact

First and Last Name:    

Relationship to student:

 Phone: 

 

 

How did you hear about CHBA?

Online (via a search engine)

Brochure

Craigslist

A Friend (if so whom?)

Other (Please tell us how you found out about our organization)

 

Ethnicity of student: 

Optional, we use this information when applying for grants. 

American Indian  Asian  Black  White  Hispanic  Other
(Please check one)