Disneyland Payment Form
Parent Name
First Name
Last Name
Student Name
First Name
Last Name
Other attendees, chaperones, family members and student names
Use this text box only if purchasing more than one chaperone/guardian/family additional ticket
Parent Email
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Band or Orchestra Student Fee
$
285.00
Fee for performing Band or Orchestra students
Total number of performing students (performing siblings or donation)
1
2
3
4
5
6
7
8
9
10
Chaperone or family member fee
$
180.00
Fee for chaperone or additional family members
Number of of additional fees
1
2
3
4
5
6
7
8
9
10
Guitar Student Fee
$
240.00
Fee for non-performing Guitar students
Quantity
1
2
3
4
5
6
7
8
9
10
Total
$
0.00
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