To Be Completed by Parent or Gaurdian: (Please PRINT Clearly)


Name of Student:_______________________________________________________________________

School (2018/19):_______________________________________________  Grade (2018/19):________

Parent/Gaurdian Name:_________________________________________________________________

Address:_______________________________________________________  Postal Code:____________

Parent Telephone: (home)__________________  (work)_________________  (cell)_________________

Parents Email Address(s) (will be added to the band email list to receive band updates, notes, reminder):



Instrument:______________________________      Second Choice for Gr. 6 Only____________________

Please Check One:

_______ I am able to provide an instrument for my child.  (Instruments can be rented through St. John’s Music or Long & McQuade Music.)

_______ My child has chosen an instrument that is rented through the school board.  These instruments included: Tuba, Baritone, Bass Clarinet, Baritone Saxophone and French Horn.  I am able to pay the yearly $150 instrument rental fee, issued in September 2018.

_______ I need help getting an instrument for my child.  I would like to be contacted by the band teachers for other options.

The annual band fee of $50 for Full Band transportation is payable in the Fall of 2018.  Payments can be made from Septmeber 1, 2018 to September 30, 2018.  Please use the perfered online payment method.  Cheques payable to your child’s school or cash will be accepted.  Refunds will only be granted before October 31, 2018 and will be adjusted for services provided.

Will you use the online payment system for transpotation fee in Sept. 2018:  _____Yes   _____No


Parent Signature:_______________________________________________Date:___________________



To Be Completed By Band Teacher

Payment Method: _____ Online                _____ Cheque                  _____Cash              _____Equity