Community Music Registration

2022-23 COMMUNITY MUSIC REGISTRATION FORM

Select Ensemble*
- Enrichment Band (0-2 yrs' experience)
- Enrichment Orchestra (0-2 yrs' experience)
- Full Orchestra - winds, brass, percussion, strings (2+ yrs' experience)
Name*
First Last
Adult/Student Grade Fall 2022*
- Student Grade 3-5
- Student Grade 6-8
- Student Grade 9-12
- College Student
- Adult
Instrument*
Please select from the drop down list above.
Experience on primary instrument*
Parent Name (if under 21)
First Last
Phone Number*
Email*
Home Address*
Street Address City State ZIP Code
Consent*
I approve the agreement below.
I understand that by registering for this program, I irrevocably release the Encore Community Music Association, Carroll County Arts Council, Winters Mill High School and Carroll County Government from any and all claims or liability arising from the activity, the instructors or any other person participating in the program. I also agree that photographs taken of my child or myself while participating in this activity may be used for publicity purposes. I understand it is my responsibility that I/my child attend rehearsals and agree to make payments at the beginning of each semester. I hereby give permission for my child/myself to participate in the Encore Community Music Program.
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