Mount Vernon Nazarene University

Looks like you're using Safari! To complete your transaction you'll need to open the form in a new tab. Click the button below to continue.

This Form is in Test Mode

This form is not ready to process live transactions.

YOUR TRANSACTION DATA WILL NOT BE SAVED.

*** If you feel you are getting this message in error, please check
with the administrator of the site that sent you to this form. ***

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

MVNU COMMUNITY MUSIC SCHOOL

SUMMER YOUTH BAND REGISTRTION

The MVNU Community School is pleased to sponsor a Summer Youth Band program. Youth Band is intended for students who have completed the beginning year of band through 8th grade. The program will meet at Mount Vernon Middle School on Tuesdays and Thursdays from 5:30-7:30pm, beginning Tuesday, June 14th. The program will culminate with a final concert at 6:30 on Thursday, June 30th in the Mount Vernon High School Theater.

The fee to participate is $60. All participants receive a youth band t-shirt. Rehearsals each week will include fundamentals, sectionals, and full band practice. Instructors for the program are John Packard, Julia Haller, and Heather Faulkner.

Registration deadline extended! Register by Monday, June 6. For additional information and questions, e-mail communitymusic@mvnu.edu.

Youth Band Registration

If you will be registering multiple students, you will need to fill out a separate form for each student. A registration fee is charged for each registrant.

Qty

Description

Amount

Total

Summer Youth Band Fee

$60.00

---

Total: $0.00

Student information

Name: *

Current School: *

Grade (or age): *

Instrument: *

Parent/Guardian Information

First Name: *

Last Name: *

Billing Address: *

This is the address where your credit card statements are mailed.

Address 2:

City: *

State / Province: *

Zip Code: *

Country: *

Telephone:

E-mail: *

A receipt will be e-mailed to this address.

Release of liability and parental consent

1. I agree to release Mount Vernon Nazarene University and Mount Vernon City Schools from any liability for damages incurred as a result of the use of facilities or participation in the summer youth band program.

2. It is understood that each parent or guardian (or adult student) takes full responsibility for the supervision of their child (children)(self) outside of class time. Any injury or accident that occurs shall be the responsibility of the parent or guardian.

3. My child's (my) photo may be used for promotional purposes including print and internet.

I have read and understand the above statement and all the above information is true.

Your Payment Information

Name on Card: *

Card Number: *

Security Code: *

Expiration Date: *