Jazz Ensemble Registration - Plainfield Central High School Band

"*" indicates required fields

Student Information

Student Name*

Student First Student Last

Grade in School*

Student's School Email Address (@psd202.org)*

Student Email Confirm Email

Concert Band Instrument*

Preferred Jazz Instrument*

Jazz Instrument Needs*

I personally own this instrument

I need to borrow an instrument from PCHS

Please review the jazz season calendar and submit any conflicts below. Include other activities you are involved in, if they conflict with rehearsals, and please check all the performance dates and note all conflicts here.

Acknowledgement of Calendar/Schedule*

You must check the box below indicating you have seen the jazz season calendar, added dates to your personal calendar(s), and listed all known conflicts above.

I Understand

Jazz Combo Interest*

A jazz combo is a small ensemble consisting of a rhythm section and a few horns where students have more choice in the music performed and learn a lot more (through experience) about improvising and chord progressions. Depending on interest, we will form multiple jazz combos this year. All combos will rehearse on Fridays from 2:30-3:30 PM.

Yes

Audition Link*

Please upload your audition materials to YouTube as an unlisted video and then paste the link to your audition here.

Parent/Guardian Information

Primary Parent/Guardian Name*

Primary P/G First Name Primary P/G Last Name

Primary Parent/Guardian Email Address*

Primary P/G Email Confirm Email

Primary Parent/Guardian Cell Phone Number*

Second Parent/Guardian Name

Second P/G First Name Second P/G Last Name

Second Parent/Guardian Email Address

Second P/G Email Confirm Email

Second Parent/Guardian Cell Phone Number

Trip Permission/Information

I hereby give permission for the student named above to participate in all jazz band activities to be transported by school bus or personal vehicle.

Emergency Medical Aid*

In the event of a medical emergency, I give permission for District 202 personnel to secure emergency medical services if needed.
Please understand that by selecting No, you are asking D202 personnel to contact you BEFORE securing potentially life-saving medical assistance.

Yes, please secure emergency medical assistance

No, please contact me before securing medical assistance

Important Health Information About My Student

Please list any medical conditions, allergies, or other important information.

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