EYPB REGISTRATION FORM (Cash or e-Transfer)

Emergency Information

The following information is kept on file by the Registrar Coordinator. If you have a pre-existing medical condition, you must provide the Registrar Coordinator written confirmation from a medical professional that your participation and attendance at band activities will not cause the health and safety of you or anyone else to be at risk. This information will only be shared with the instructional staff or designated chaperone as required and will remain confidential.
Player 1
Date of Birth*

MonthDayYear
Date
Healthcare Number*
Medical information: please list any important medical information we should be aware of
Player 2
Date of Birth*

MonthDayYear
Date
Healthcare Number*
Medical information: please list any important medical information we should be aware of
Player 3
Date of Birth*

MonthDayYear
Date
Healthcare Number*
Medical information: please list any important medical information we should be aware of
Emergency Contact

(other than parents/guardians mentioned above)
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Relationship to Player(s)*

Fees and Commitment

Fees due at registration include association membership, tuition, instruments and bingo commitment deposit
1. Association Membership Fee (per family): $50
Membership Term: September 1, 2024 until September 1, 2025. Any member not renewing their membership at the end of the term must return all band property by the end of the term.

Membership requires the commitment of families to support fundraising efforts, such as volunteering for 8 bingo shifts each year (per family)*. Up to two casino shifts are also required (if there is a casino to work in the membership year). The implications of exceeding or not meeting the minimum are as follows:
- Failure to complete the 8 shifts: A bingo commitment deposit of $400 will be collected at Fall registration and refunded upon completion of the 4 shifts. If 4 shifts are not completed by January (including January 2025 Bingo) this may affect the members ability to participate in Winter 2025 term (February-August)

- Another bingo commitment deposit of $400 will be collected in February and refunded upon completion of all required shifts completed by August 2025. If 4 shifts are not completed by August (including August 2025 Bingo) this may affect the members ability to register for 2025/2026 year

-Working additional bingo shifts exceeding the 8 regular commitments: account credit** - $50

- “Special Bingo”*** event in addition to the regular 8 commitment nights: account credit -$100

* Subject to change based on the size of our membership (but no more than 8). For students that register in January, the number of bingos is halved.

** An account credit is reconciled at the end of each year and can be applied to offset the following year’s membership and tuition fees. It is not a cash equivalent, is non-transferable, and is dissolved when the family leaves the association.

*** For example, a Canada Day bingo or a New Year’s Eve Gala.

A signed Volunteer Commitment Agreement is required for each family
Any uniform or equipment rentals will require a signed Equipment and Uniform Fees form at the time of issue
Membership assumes that you will at all times abide with the ‘bylaws’ and ‘code of conduct’ of the association. Behaviour expected of band members at practice is the same as expected in a school environment.
2. Tuition Fees (per student)
a) $150 for the full year (starting in September)

b) $75 for a half year (starting at the registration event in January)

My Products

Membership Fee (per family)

$50.00CAD

Full Year Tuition Fee (per player)Select this if player(s) will be participating for the full registration period

$150.00CAD Quantity
Item subtotal:$0.00CAD

Bingo Shift Advance (Per family)$400 for the fall term-Sept and $400 Winter Term-Feb), to be refunded upon completion of the required number of shifts for this year Please select 1 or 2 based on length of player tuition.

$400.00CAD Quantity
Item subtotal:$0.00CAD

Chanter

$69.00CAD Quantity

Drum Pad

$30.00CAD Quantity

Drum Sticks

$19.75CAD Quantity

Earbuds

$24.00CAD Quantity

Enter coupon

Total

$0.00CAD

Waiver
I, the undersigned Band Member/legal guardian of the undersigned Band Member, acknowledge that my participation in band practice and related events with The Edmonton Boys’ Pipe Band Association before, during or after practices, performances, competitions or otherwise, and both within and outside The Edmonton Boys’ Pipe Band Association designated practice location or performance/competition locations, including travel to or therefrom (the “Activities”)

a) is strictly voluntary, and

b) may result in the sustaining of Loss which includes but is not restricted to:

i. bodily or personal injury

ii. damage to, or loss of, property; and

iii. consequential loss and/or damages.

In consideration of being allowed to participate in the Activities with The Edmonton Boys’ Pipe Band Association, I accept any and all responsibility for, and risk of, any and all Loss which I may sustain or incur by reason of my participation in the Activities, and save harmless The Edmonton Boys’ Pipe Band Association and its Directors, officers, servants, agents and employees from any and all claims which I, or any person with a legal right to claim through me, shall or may have for such Loss, howsoever caused.
Dated at the City of Edmonton in the Province of Alberta*

MonthDayYear
Date
Acknowledgement of Band Member or Guardian (where Band Member is under 18 years of age)

I, the undersigned Parent or Guardian of the Band Member named herein, who is in my actual custody, acknowledge that I have read and understand the Waiver and Consent to which this Acknowledgement is attached. I consent and agree to the terms and the binding effect thereof as they relate to my child and hereby indemnify The Edmonton Boys’ Pipe Band Association from and against claims which may arise.
Acknowledgement of Parent/Guardian

If Band Member is under the age of 18
Full Name of Parent/Guardian *

First NameLast Name
Signature of Parent/Guardian*

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Date*

MonthDayYear
Date
Acknowledgement of Band Member:
Full Name of Band Member*

First NameLast Name
Signature of Band Member*

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Date*

MonthDayYear
Date
Acknowledgement of second Band Member (if applicable):
Full Name of second Band Member*

First NameLast Name
Signature of Band Member*

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Date*

MonthDayYear
Date
Acknowledgement of third Band Member (if applicable):
Full Name of third Band Member*

First NameLast Name
Signature of Band Member*

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Date*

MonthDayYear
Date

Use of Photo or Video - Consent
Under the Freedom of Information and Protection of Privacy Act (FOIP), it is necessary for The Edmonton Boys’ Pipe Band Association to obtain consent to use photos and/or video footage of people for the purposes identified below.

Your consent gives The Edmonton Boys’ Pipe Band Association the right to use images (still or moving) in different media. These may include but are not limited to newspaper ads, brochures, newsletters and other print materials; transit advertising; and on The Edmonton Boys’ Pipe Band Association website, social media web sites and other internet-based formats. Though the images will be used only by The Edmonton Boys’ Pipe Band Association, the materials they are used in may be distributed elsewhere.

Consent for Collection and Use

I acknowledge that certain personal information, including my name or my child’s name and photographic or video image, is collected, from time to time by The Edmonton Boys’ Pipe Band Association and is required by The Edmonton Boys’ Pipe Band Association for its continued and effective operation.

I hereby irrevocably consent to the use of such personal information by The Edmonton Boys’ Pipe Band Association in connection with its operation and, including but not restricted to, use in connection with any advertisement, marketing product, broadcast, publication, audio or video recordings, still photographs and artistic renderings without compensation and I waive the right to inspect or approve any such use in connection therewith.
Dated at the City of Edmonton in the Province of Alberta*

MonthDayYear
Date
Acknowledgement of Parent or Guardian (where Band Member is under 18 years of age)

I, the undersigned Parent or Guardian of the Band Member named herein, who is in my actual custody, acknowledge that I have read and understand “Part D Use of Photo or Video – Consent” to which this Acknowledgement is applied. I consent and agree to the terms and the binding effect thereof as they relate to my child and hereby indemnify The Edmonton Boys’ Pipe Band Association from and against claims which may arise.
Acknowledgement of Parent/Guardian

If Band Member is under the age of 18
Full Name of Parent/Guardian *

First NameLast Name
Signature of Parent/Guardian*

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Date*

MonthDayYear
Date
Acknowledgement of Band Member:
Full Name of Band Member*

First NameLast Name
Signature of Band Member*

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Date*

MonthDayYear
Date
Acknowledgement of second Band Member:
Full Name of second Band Member*

First NameLast Name
Signature of Band Member*

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Date*

MonthDayYear
Date
Acknowledgement of third Band Member:
Full Name of third Band Member*

First NameLast Name
Signature of Band Member*

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Date*

MonthDayYear
Date

MISCELLANEOUS
Volunteering

We are a volunteer-run organization and welcome any help that parents may provide. Please list any applicable skills that you could contribute to the success of the association, or types of jobs that you would be interested in doing. Examples: photography, graphic design, video editing, legal advice, secretarial qualifications, accounting, connection to the school districts, connection to printing companies, and so on.
Skills
How did you hear about us? (for new members)

Google SearchSocial mediaWebsiteWord of mouthOther
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REGISTRATION FORM

Player(s)

Parents/Guardians

Emergency Information

Player 1

Player 2

Player 3

Emergency Contact

Fees and Commitment

1. Association Membership Fee (per family): $50

2. Tuition Fees (per student)

Waiver

Acknowledgement of Parent/Guardian

Acknowledgement of Band Member:

Acknowledgement of second Band Member (if applicable):

Acknowledgement of third Band Member (if applicable):

Use of Photo or Video - Consent

Acknowledgement of Parent/Guardian

Acknowledgement of Band Member:

Acknowledgement of second Band Member:

Acknowledgement of third Band Member:

MISCELLANEOUS

Volunteering