Forms

Required Band Information:

* Indicates required field

Student's Full Name *

Emergency Contact

Parent/Guardian's Full Name: *

Phone Number: *

2nd Parent/Guardian's Full Name: *

Phone Number (2nd): *

Additional Emergency Contact Person's Full Name: *

Phone Number (additional): *

Please list any allergies, medical problems, and medications if applicable: *

Insurance Card Information:

Name of Insurance Company: (type 'none' if not available) *

Policy Number: *

Phone Number (Insurance): *

Group Number: *

Handbooks Acknowledgement / Consent to Treat Minor

• I, the undersigned parent or guardian for the student named above, have read both the NCHS and NCISD Band Handbooks and understand the rules and regulations. I agree to the stipulations set forth in the handbook, and also expect my child to abide by them.

• I give my child permission to travel with the band on any school sponsored band trip that may occur during the 2020-2021 school year.

• I do hereby authorize a school employee/chaperone to obtain medical treatment by a licensed physician at an office or hospital if required.

Parent/Guardian: Type in your full name to sign. *

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