John Champe Summer Band 2018

Jazz Band

This is an optional Jazz Section of the John Champe Summer Band. The cost is an extra $78. Students in the Jazz portion meet 8:15-9:00AM every morning prior to the start of the other portion of the John Champe Summer Band. This option is NOT available for students who have never played before.
Would you like to do add jazz band portion of the John Champe Summer Band?

Yes No

Medical Information
Additional Guardian *

First Name Last Name
Cell Phone Number *

- Area Code Phone Number
Emergency Contact in case a parent can not be reached *

First Name Last Name
Relationship to Participant *
Phone Number *

- Area Code Phone Number
Family Doctor Name: *
Phone Number *

- Area Code Phone Number
List only Acute, Life Threatening Conditions, or Medications of which Student is Allergic: *
None
List any allergies, health conditions, regular medications taken, or activity restrictions we need to be aware of: *
None
Medical/Accident Insurance? *

Yes No
Name of Insurance Co.
Policy Number:
I ___DO ___ DO NOT grant permission for myself or my child (named above) to be photographed, taped, recorded or featured in any video, audio, or televised recording, live broadcast, webcast, or printed publication that may be produced by and available to the public from LCPS (to the extent that access is within LCPS’ control during school hours). *

DO DO NOT
I ___DO ___ DO NOT grant permission for photographs to be posted on school websites or appear in newspapers, brochures, event programs, vendor advertisements, web-sites, etc. *

DO DO NOT
I understand that LCPS and John Champe High School will not be responsible for any personal property that may become lost or damaged in the course of this activity.

I understand that in the case of an accident, injury, or serious illness during participation in the John Champe Summer Band, an effort will be made to contact me as soon as possible at the numbers listed above. In any event, I give authorization to LCPS and John Champe High School for my child to receive first aid, emergency medical treatment, 911 transport, and all other medical care deemed reasonably necessary to my child’s health and well-being. I understand that I will be responsible for any medical expenses or other financial obligations incurred.

I understand that my student must be picked up from John Champe High School immediately at the conclusion of John Champe Summer Band (12:00 Noon). There is no supervision for students after this point.

Because staff is hired based on the number of students who register, we are unable to refund money for students who are no longer able to attend after payment is made. I understand that once I pay, my son or daughter's spot at summer band is reserved and there are no refunds.
E-Signature: By signing here you agree to the above stated expectations and policies: *

Clear

Payment:

The fee for John Champe Summer Band is $229.15 including processing fee. With tuition, each student receives one method book, sheet music, 30 hours of instruction, a digital photomate, and one ice cream following the concert on June 29th. After June 1, 2018, the fee will be $281.15. The extra jazz class is $78 and is NOT for beginners. Once you submit, you will see a link to go to the online school payment system.
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