subject_line
Palm Beach County Youth Orchestra
2285 Potomac Road,
Boca Raton, FL 33431
www.yopbc.org
2020-21 YOPBC Music Prep Academy 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
if paid in full by October 15, 2020.
Please complete one form for each musician.
FAMILY INFORMATION
Musician First Name
*
Last Name
*
Instrument
*
Address
*
City
*
State
*
Zipcode
*
Phone Number
*
Musician Email/if applicable
Gender
*
M
F
Birth Date
*
+
Relationship to Participant:
*
Self
Mother
Father
Guardian
Other
Other
Primary Contact Name:
*
Primary contact Email:
*
Preferred Phone:
*
Secondary contact: Relationship to Participant:
Self
Mother
Father
Guardian
Other
Other
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)
*
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Does your school have an instrumental/music program?
*
Yes
No
How did you hear about us?
*
Word of mouth
Advertisement (Print media - Radio-Magazines)
Internet
Facebook
Instagram
Other
Other
Parent/Member acknowledgements:
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
2020-21 PREP ACADEMY TUITION PAYMENTS. After October 15, 2020 tuition increases. Register now and save!
$200 per student
CREDIT CARD PAYMENTS Select below: A Credit Card Convenience Fee $20 added to tuition per musician
*
Prep Academy half year enrollment ($200 + $20.00)
Non-refundable administration fee ($25.00)
Current Total:
$0.00
Calculate
CHECK PAYMENTS:
For check payments t
he rates above apply. P
lease 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