Palm Beach County Youth Orchestra
2285 Potomac Road, Boca Raton, FL 33431

2020-21 REGISTRATION FORM

Due to the Covid - 19 pandemic YOPBC is delaying its 2020-21 season until January of 2021. Accordingly we will have a half season. Tuition will be cut in half for

Training Orchestra, Chamber Ensembles, String Orchestra, Symphony Orchestra and Philharmonic Orchestra if paid in full by October 15, 2020.

PLEASE COMPLETE ONE REGISTRATION FOR EACH MUSICIAN

FAMILY INFORMATION

Musician First Name *

Last Name *

YOPBC Member since:

Orchestra:

Instrument *

Address *

City *

State *

Zipcode *

Phone Number *

Musician Email/if applicable

Gender *

Birth Date * +

Relationship to Participant: *

Primary Contact Name: *

Primary contact Email: *

Preferred Phone: *

Secondary contact: Relationship to Participant:

Secondary Contact Name:

Secondary Phone :

Secondary Email:

If Applicable additional mailing address if different from musician's address listed above

Medical Form

Complete, print & bring to first day of season start

SCHOOL/TEACHER INFORMATION

School: *

Grade (year of registration) *

School conductor/director name or private teacher (if applicable)

Private teacher email address for invitations to performances

How did you hear about us? *

Parent/Member acknowledgements:

Release from Concerts (Philharmonic only) *

Musician must be signed out by parents after concerts

Musician may leave without parent consent

By signing this application you agree that:

MEDIA RELEASE: YOPBC may use photos/videos musician for promotional materials such as print, YOPBC website and/or Facebook

RULES & REGULATIONS: I agree to abide by the rules and policies of YPBOC as outlined in the YOPBC Musician Handbook. I understand and agree to the ateendance policy for rehearsals and concerts.

YOPBC reserves the right to terminate my participation if I do not follow the rules and policies in the YOPBC handbook. For more information on the refund policy and other policies please refer to the YOPBC Musician Handbook.

I FULLY UNDERSTAND THE ABOVE YOPBC RULES & POLICIES *

YES

Signature (use your mouse to sign your name) *

clear

Formatted Text

CREDIT CARD PAYMENTS Select below: A Credit Card Convenience Fee $20 added to tuition per musician *

Philharmonic Orchestra ($350 + $20.00)

Symphony Orchestra ($350 + $20.00)

String Orchestra ($350 + $20.00)

Training Orchestra ($250 + $20.00)

Chamber Ensembles ($150 + $20.00)

Non-refundable administration fee ($25.00)

Current Total:

$0.00

CHECK PAYMENTS:

For check payments the rates above apply. Please complete registration by selecting"Continue"

and exclude the $20 Credit Card Convenience Fee in your check amount.

Make check out to: YOPBC

Mail to:

YOPBC

2285, Potomac Rd.,

Boca Raton, FL 33431