Easley High School Bands and Ensembles Student – Family – Medical Information

  • School District of Pickens County
    1348 Griffin Mill Road
    Easley, South Carolina 29640

  • Permission to Participate & Travel

  • School: Easley High School Address: 154 Green Wave Boulevard Easley, SC 29642
  • Event: All Band Activities for the 2026-2027 school year.
  • Dates: July 2026-June 2027
  • *OPT OUT Media/Photos/Videos Release*
    (if you wish your child not to be used please do NOT SIGN)
  • Date:
     - -
  • Method of Transportation: School Buses, Activity Buses, or Charter Buses
  • Image field 12
  • Date
     - -
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Image field 20
  • No, the above named student may not participate in this event/events.
  • Date
     - -
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • Easley High School Bands and Ensembles Student – Family – Medical Information

  • This form will be used for all events sponsored by Easley High School Bands and Ensembles If any of the information changes, please contact the school office 864-397-3212

  • Student Information:

  • Student Date of Birth: MM/DD/YYYY
     - -
  • T Shirt Size: AS AM AL AXL A2XL A3XL circle one
  • Format: (000) 000-0000.
  • Rows
  • Rows
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • In case of a medical emergency, it is understood that every effort will be made to contact the parent/guardian. So as not to delay treatment, in the event that the parent/guardian cannot be reached, I hereby give permission to the physician or hospital selected by the group leader, or another adult authorized by them to hospitalize, secure proper treatment for and order injections, anesthesia, or surgery for the above listed minor.
  • Date:
     - -
  • Easley High School Bands and Ensembles Handbook
  • 2
  •  
  • Should be Empty: