.:: Spring Registration 2009::.

Please mail your registration fee to:
Youth Music Outreach
PO Box 300008
Escondido, CA 92030

Student(s) Name:
*

Parent’s Name:
*

Address:
*

City, State Zip:
*

Home Phone:
*

Cell Phone:

E-mail Address:
(parent)
*

How did you hear about the YMO 2011 Spring Semester?

Band Director
School
Private Instructor
YMO Website
Other Website
Magazine Ad
Music Store
Friend
Other

Birthdate ( in order of names above):
*

Gender: Male Female

Primary Instrument:

Years Played:

Secondary Instrument(s):
(if applicable)

Years Played:

Private Instructor’s Name:
(if applicable)

Band Director’s Name:
(if applicable)

Church:
(if applicable)

School:

E-mail Address:
(student)

Which ensemble do you plan on attending?
La Mirada Beginning Band e
Intermediate Jazz Band
Intermediate Band
Concert Band e
Wind Ensemble eeeeeeee e
e Jazz Band

Please note any medical conditions or allergies (especially to food):
(All students will be given a medical release form in registration packet.)

If accepted into the YMO 2011 Summer Camp,I agree to participate in all events and activities.
I further agree to abide by all rules and regulations.

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