Sports Registration: Concordia Lutheran School Christ-centered

Fine Arts Registration Form

Welcome to Concordia Fine Arts!

Which activity are you registering for?(Required)

Student's Name(Required)

Student's Grade During Selected Activity(Required)

Parent/ Guardian Name (Primary)(Required)

Email(Required)

Phone Number(Required)

Parent/ Guardian Name (Secondary)

Phone Number

Who should be notified regarding activity schedules & updates?(Required)

Contact Primary only

Contact both Primary & Secondary

Emergency Medical Authorization

Participant Date of Birth(Required)

Participant Place of Birth(Required)

Please read & Confirm Below:(Required)

I/We give permission for Concordia Lutheran School Representatives to obtain emergency medical care/treatment for my child when participating in an organized fine arts function. I//we understand that every effort will be made to contact me/us before care/treatment is administered.

Student's Medical History(Required)

Please list any medical condition we should be aware of as well as any allergies to medications, food, insects, etc

Insurance Carrier(Required)

Insured Name(Required)

Policy Number(Required)

Emergency Contact(Required)

Home Number(Required)

Cell Number(Required)

Emergency Contact

Home Number

Cell Number

Emergency Contact

Home Number

Cell Number

Fine Arts Participation & Transportation

Instrumental Rental Agreement

Instrument

Instrument Serial Number

Instrument Condition at Time of Rental

Instrument Rental Fee

Uniform Rental Agreement

Uniform Rental Fee(Required)

Parent/Guardian eSignature(Required)

Participant eSignature(Required)

I understand that to participate in this activity I must comply with the regulations stated above and in the handbook.

Total Amount Due To MPO

Payment Notice

Please note that payment to the Music Parent Organization for your Uniform and/or rental instrument is required for your forms to be processed.

Participation Fee

Your participation fee will be added to your family account to be paid through the School Office.

Band: $500
Strings: $500
Chorus: $100
Theater: $60