2011 HONOR BAND STUDENT APPLICATION FORM

If accepted, participation fee is $25.00 per student.

Your director will be billed these fees; see your director for details.

NOTE:Return Application & Participation Form to your director; director must turn these in with audition tape/CDby 4:30 pm, November 4, 2010

Student Name:______Date: ______

Home Mailing Address:______

Street or P.O. Box

City:______Zip:______Phone: ______

School:______Director:______Instrument:______

Grade Level: Freshman □ Sophomore □ Junior □ Senior □

Years of participation in High School County Honor Band

(Check all that apply)

□ 2010 □ 2009 □ 2008

Have you been accepted to the Regional or State level Honor Band Program?

□ No □ Yes, date of acceptance______and location ______

Agreement

Applications will not be accepted without complete signatures and initials

*If accepted into the San Joaquin County High School Honor Band, I agree to attend all rehearsals and concert as outlined

below.______Initial

*I understand that missing any rehearsal in part or in its entirety is cause for my dismissal and forfeiture of all fees.______Initial

*Further, it is understood that the San Joaquin County Office of Education, theSJCMEA or its sponsors do not assume any

responsibility of liability for the actions and/or conduct of students participating in the Honors Concert.______Initial

Signatures:

______

Student Signature Parent/Guardian Signature

Band Schedule

Date / Activity / Time / Location
November 4, 2010 (TH) / Tape Audition / 4:30 pm / SJCOE, Kingston/Alpine Rooms
November 18, 2010 (TH) / Live Audition / 4:45-7:00 pm / Holt 213,Holt Practice Rms.
Rehearsal #1 / 7-9:00 pm / Holt 113
January 6, 2011 (TH) / Rehearsal #2 / 5:45-9:00 pm / Holt 113
January 7, 2011 (FR) / Rehearsal #3 / 8:45-3:00 pm / Holt 113 & Atherton Auditorium
January 8, 2011 (SA) / Rehearsal #4 / 8:45-12:00 noon / Atherton Auditorium
Concert / 7:00pm (Call time 6:30) / Atherton Auditorium

Participation Form

NAME OF STUDENT ______

FirstMiddle InitialLast

now a student at ______

School Name School District

in grade ______with date of birth of ______

wishes to participate in the San Joaquin County High School Honors Concert, a voluntary event, to be held at DeltaCommunity College, Atherton Auditorium in Stockton on Saturday, January 8, 2011at 7:00 pm with prior rehearsals held in November 2010 and the week of January 3, 2011 at Holt 113 and 213, DeltaCollege. Pursuant to California Education Code Section 35330, I understand that I hold the San Joaquin County Office of Education, its agents and employees, harmless for any and all liability or claims, which may arise out of or in connection with my child’s participation in this activity. My signature is shown below and I hereby agree to have my son/daughter follow the rules of Agreement on the Student Application. By signing this request I acknowledge that I have carefully read this voluntary participation form and expressly grant authority to, and indicate consent to, the possible release of educational information about or relative to, the participation of this student in Honors Concert-related activities. Such information shall include, but not be limited to, the release of photographs, names and instruments or voices, the reproduction of sound, motion picture or video tape recording, etc. The CountyOffice shall have the right to reproduce, use, display and disseminate in such manner as they see fit, without obligation of any kind to any person, information from Honors Concert-related activities.

Student Signature______Date ______

Parent/Guardian Signature ______Date ______

NOTE: No student is allowed to participate without a signed completely filled-out participation formAND a signed and

completed application.