#ConquerCarnegie Chaperone Interest Form

Please submit this form by Tuesday, December 17!

Name

First NameLast Name

Email

example@example.com

Please specify who in your family is interested in chaperoning?

Have you chaperoned with us before? Have you chaperoned other student groups before?

(Please answer for each person individually)

Please tell us the status of your clearances? (FBI Fingerprinting, Child Abuse, Criminal History) Are they on file with TRYPO, or have you received them recently? (Must be current within 60 months of the final day of engagement with our students.)

(Please answer for each person individually)

Do you have any medical training/certification that would be helpful?

(Please answer for each person individually)

Is there anything else we should know about you?

Payment terms: I understand that if I/we are selected to chaperone, that $400/chaperone will be invoiced and I will either pay in full or pay a $200 deposit on my invoice quickly, with the balance due by January 31. This is based on double occupancy in the hotel. I understand that TRYPO is off-setting some of the costs for me to participate. If I would like my own hotel room, I understand that I will be charged more.*

I accept the chaperone terms and payment terms as stated ($400/chaperone and double occupancy in the hotel).I accept the chaperone terms and payment terms as stated. I don't need the off-set chaperone fee. I am happy to pay the full amount for myself ($600/chaperone and double occupancy in the hotel).I accept the chaperone terms and payments as stated. If selected, I would like to upgrade for my own room and not share with someone else. I understand I will pay the difference (TRYPO will find out the number and let you know).

Please note that your choices on the last question do not impact whether or not you are selected to chaperone! It just will help us set up your invoicing once the chaperones have been finalized because of the tight turn-around!

Chaperoning Terms: If I am selected, I agree to chaperone the TRYPO trip to Carnegie Hall March 30-April 1, 2019. I understand that I will travel with the group on the bus, stay in the hotel with the group, and follow the entire group itinerary. I will be paired with another chaperone and our chaperone team will oversee between 10-16 young musicians together. I will read and adhere to the terms of the TRYPO Safe Environment for Children Policy (will be issued to all confirmed chaperones). I will do my best to provide a safe, educational, and calm environment for the members of TRYPO so they can have the best experience possible.*

I accept the chaperoning terms.