BLUE ASH YOUTH SYMPHONY ORCHESTRA

STUDENT REGISTRATION FORM

2007-2008

GENERAL INFORMATION: PLEASE PRINT CLEARLY!

Name(as you want it to appear on the program)____________________________________

Home Phone ( )______________________________

Address ________________________________________________________________

Street City State Zipcode

Name of Parent (both) or Guardian____________________________________________

Parent’s work phone(s) ______________________________________________________

Parent’s email(s)______________________ __________________________________

Student’s email___________________________________________________________

MUSIC BACKGROUND

Instrument(s)_______________________________ # of years in private lessons_______

Name of school______________________________Grade_________

School Music Director(s)___________________________________________________

Private Music Instructor___________________________________________________

EMERGENCY CONTACT IF PARENT(S) CANNOT BE REACHED

Name______________________________________Phone Number_________________

Parent Signature_______________________________________________________

PLEASE BRING THIS COMPLETED FORM AND $150 (PAYABLE TO BAYSO)

ON AUGUST 20 OR THE FIST REHEARSAL ON MONDAY, SEPTEMBER 10 2007