Registration: 2023-2024

Emergency Contact
Emergency Contact: *

First NameLast Name
Emergency Contact Relationship to Student*
Parents cannot be listed as emergency contact (example: not parent 1 or parent 2)
Emergency Contact Phone*
Please enter a valid phone number.
Health and Medical Information

Please list N/A for items that do not apply to this student.
Student Food Allergies
Student Medicinal Allergies
Other Allergies
Medical Alerts/Notices
Does your child have any behavioral/learning differences? (ex. ADHD, Autism Spectrum Disorder, Anxiety, etc.)*

YesNo
Please explain:
Doctor's Name*

First NameLast Name
Doctor's Phone*
Please enter a valid phone number.
Health Insurance:*
Health Insurance Provider*
Group Number*
Member Number
Volunteering
Family Volunteer Requirements*
SFYSA strives to provide the highest quality music education at an affordable rate. However, tuition covers 33% of costs and SFYSA depends on the service of families to assist with necessary fundraisers, concerts and other special events. WE REQUIRE EACH FAMILY TO PROVIDE 5 HOURS OF VOLUNTEER SERVICE DURING THE SEASON. There are many activities that take place, so there is something for everyone! We appreciate your help. Please select yes to show that you understand.
Please describe what other volunteering interests you have, skillsets, etc.
Volunteering Interest*
Behavior, Attendance, and Preparation Agreement
To maintain membership in your SFYSA program, students must maintain:
- Excellent attendance and be punctual to all classes
- Show exemplary classroom behavior
- Participate in all performances
- Practice and prepare music through at home practice
- Adhere to the SFYSA handbook for their program
If a student fails to adhere to the Behavior, Attendance, and Prepartation Agreement, they may be placed on probation for a period of one semester. If the agreement is not upheld during the probationary period, the student may become ineligible for membership in future seasons.
*

I and my student agree to the Behavior, Attendance, and Preparation Agreement
Release and Waivers
Permission to Participate*
As the parent/guardian, I hereby give permission for this student to participate in the programs and activities of the SFYSA including rehearsals, performances, tours, retreats, and fundraising activities. I hereby release SFYSA from any and all claims, damages, or other liabilities which may be asserted as a result of the students participation in the activity, or any injury, loss, damage, or incident occurring during such participation.
Health/Emergency Consent*
I agree that the SFYSA may obtain medical attention, advice, evaluation, or treatment for my child in an emergency while participating in SFYSA events. In case of emergency, I understand that reasonable efforts will be made by SFYSA to contact me. In the event of an emergency, I agree to pay for any medical services that might be needed beyond that provided by my insurance. I hereby give my permission for the administration of over-the-counter medications by a SFYSA staff member. I agree and understand that the Santa Fe Youth Symphony Association has sole discretion to determine when such an emergency has occurred.
Parent/Guardian Obligations*
As a parent/guardian of a SFYSA member, I realize my obligation to the SFYSA and my student. I will keep current with my financial and service obligations. I will make sure that my student's SFYSA schedule is followed and that he/she is a contributing member of the organization. I further understand that excessive absences and tardies, inappropriate behavior, and unfulfilled obligations both musical and financial will be cause for dismissal from the SFYSA. I will pay for damage to music or property, if any that occurs is a result of my student's behavior. As a parent of a student in this ensemble, I agree to have my student(s) at the dress rehearsals and performances.
Financial Commitment*
Please check the box to indicate your understanding that you are assuming a financial obligation and that you are solely responsible for making sure tuition is paid.
Image and Video Release*
As part of our outreach and funding reports we may take photographs and videos of our children in action as they participate in classes, rehearsals, fundraisers, and concerts. We also post images and video on our website and social media. Please indicate if you give your consent for us to use your child's image for these purposes.
Please explain what you will and will not allow. We anticipate taking videos of concerts, group pictures of classes, and rehearsals. (ex. we will allow group shots, but no individual shots). Please keep in mind that not allowing us to take videos of performances impacts our grant funding, ability to share with out of town families, etc.*

By selecting "I AGREE" and by signing below, I confirm that the information provided is correct. I also understand that registration is NOT complete until I submit a payment form and make the appropriate payment depending on my tuition selection (in full, by semester, by month or financial aid).*

I AGREE
Signature*

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Please fill out ONE form for each student that you are registering

Student Information

Student Education Information

Household Information

Emergency Contact

Health and Medical Information

Volunteering

Behavior, Attendance, and Preparation Agreement

Release and Waivers