2021-2022 Registration

Band Gear

Mandatory Items for all students. Can be set up on a payment plan - 50% due at registration
Instruction (Private Lessons, Technicians, Clinics, Master Classes) *

$180
Event Meals (Football games and competitions) *

$150
Show Shirt ($15) *
Show Shirt Qty *
Show Shirt sub-total
Band Practice Shirt ($15) *
First one is no charge, it is recommended to have at least 2. If you only want the booster provided one, select 1
Band Practice Shirt Qty *
Band Practice Shorts($6) *
First one is no charge, it is recommended to have at least 2. If you only want the booster provided one, select 1
Band Practice Short Qty *
Guard Practice Shirts ($30) *
First one is no charge, it is recommended to have at least 2. If you only want the booster provided one, select 1
Guard Practice Shirts Qty *
Guard Practice Shorts ($10) *
First one is no charge, it is recommended to have at least 2. If you only want the booster provided one, select 1
Guard Practice Shorts Qty *
Instrument Usage Fee (if you do not own your instrument and will use school supplied instruments)

$40
Percussion Fee (all percussion students)

$40
Additional Items

If you are a first year band student with Harlan ALL items below must be purchased at the time of registration. Returning Harlan Band members needing replacement items can purchase them at the time of registration. These items are paid in full at registration
Compression Shorts ($13)
Compression Shorts Qty
Compression Shorts Total
Compression Shirts($13)
Compression Shirts Qty
Compression Shirts Total
Marching Shoes ($46) (previous years shoes must be approved by a director)
Travel Polo Shirt ($25)
Travel Polo Qty
Travel Polo Total
Woodwind/Brass Gloves ($10)
Price is for 2 pair
Woodwind/Brass Gloves Qty
Woodwind/Brass Gloves Total
Warm Up Jacket ($60)
Warm Up Jacket Qty
Warm Up Jacket Total
Warm Up Pants ($27)
Warm Up Pants Qty
Warm Up Pants Total
Flag Bag ($26)
Guard Gloves($15) *
Guard Gloves Qty *
Guard Gloves Total
Guard Shoes ($35)
Guard Shoes Qty
Guard Shoes Total
Water Jug ($10)
Travel Bag ($28)
Guard Practice Shorts Total
Guard Body Tight Size ($22)
Guard Body Tight Qty
Guard Body Tight Total
Guard Leggings Size ($40) *
Guard Leggings Qty *
Guard Leggings Total
Guard Long Sleeve Shirt Size ($30) *
Guard Long Sleeve Shirt Qty *
Guard Long Sleeve Shirt Total

Emergency Contacts

OTHER THAN PARENTS - Parents will always be contacted first, Emergency contacts will be contacted if parents are not reached
Emergency Contact 1 Name *

First Name Last Name
Emergency Contact 1 Phone Number *
Please enter a valid phone number.
Emergency Contact 1 Email
example@example.com
Emergency Contact 1 Relationship
Emergency Contact 2 Name

First Name Last Name
Emergency Contact 2 Phone
Please enter a valid phone number.
Emergency Contact 2 Email
example@example.com
Emergency Contact 2 Relationship
Emergency Contact 3 Name

First Name Last Name
Emergency Contact 3 Phone Number
Please enter a valid phone number.
Emergency Contact 3 Email
example@example.com
Emergency Contact 3 Relationship

Student Medical/Allergy Information

Please list any allergens (food or other)and any medical information we should be aware of. List any medicine the student should have on them at all time (inhalers, epi pen, glucose testing, etc.)
Food Allergies? *
Medical Allergies? *
Does your child take daily medication?
What Medication?
Does your student use an inhaler daily? *
If yes, they student should have it on them AT ALL TIMES! We will be checking, they will not be allowed on the bus per NISD policy
Are there any other medical issues that could impact your student during band? *
Do you give consent for the head chaperone and/or band medic to dispense OTC pain relievers to your student? *
Preference *

Acetaminophen (Tylenol) Ibuprofen (Motrin/Advil)
Do you give consent for the head chaperone and/or band medic to dispense OTC antihistamine (Benadryl or equivalent) to your student? *

Payment Arrangement Options

Payments will be equally divided over the remaining months through December 2021. If you need a different payment plan see Dr. Tucker, Harlan Band Booster President and/or Treasurer to discuss on an individual basis.
Total Mandatory Items
Additional Items Total
Total Parent Items
Total Credits from Previous Years
Registration Total
Registration Total (minus credits)
Total with Credit Card
Minimum Due At Registration
Minimum Due with Credit Card
Payment 1
Payment 1 with Credit Card Fee
Payment 2
Payment 2 with Credit Card Fee
Payment 3
Payment 3 with Credit Card Fee
*All payments should be made through personal check, money order, CutTime or with credit card Invoice emailed. Cash is least preferred as it is hard to track and for your protection. Label every check & envelope with your students name and ID number.

*Checks should be payable to Harlan Band Booster Organization

*Please note, in order to challenge a payment made to the official books, a receipt is required for verification. If the Treasurers verify no record of receipt and the family cannot provide a receipt, no credit for the transaction in question will be made and the family will be fully responsible for remitting payment.

*If Band or Guard is dropped - Refunds approved by Dr. Tucker only - less any credit card fees assessed or bank charges (NSF charges). Personalized items are non refundable. No refunds on game meals already served to the student

**No prorated fees or refunds if student is ineligible due to grades**

*If fees are not paid as agreed, the fee will be treated like any other fine and the students report card and grades will be withheld. In the event the student is a senior, they will not be able to walk at graduation or get their transcript. Underclassmen will not get their schedule for the next year.
Student Signature
Parent Signature
Board Signature
Items Issues
Approval *

Approved
Should be Empty:

2021-2022 Registration

Band Gear

Additional Items

Parent/Guardian Information

Emergency Contacts

Student Medical/Allergy Information

Payment Arrangement Options