Register – SOS Ensemble

Child's First Name

Child's Last Name

Child's Date of Birth

2nd Child's First Name

2nd Child's Last Name

2nd Child's Date of Birth

3rd Child's First Name

3rd Child's Last Name

3rd Child's Date of Birth

4th Child's First Name

4th Child's Last Name

4th Child's Date of Birth

Age

Current Grade

Current School

Primary Instrument or Section

MEDICAL & EMERGENCY INFORMATION

Relationship to Student

Registering Parent's First Name

Registering Parent's Last Name

Phone

Dp parents have a shared parental responsibility for this child?

Yes No

If no, I understand I am required to provide a copy of the court order at the time of registration

Yes No

Does your child have a IEP or 504(c) plan currently inplace?

Yes No

Non- Registering Parent's First Name

Non- Registering Parent's Last Name

Non- Registering Parent's Phone

Emergency Contact Name

Emergency Contact Number

Authorized Pickup Persons

My child has permission to walk/ride home alone.

MEDIA RELEASE

I give permission for my child’s image/video/audio to be used for SOS Ensemble promotional purposes.

I DO NOT give permission for media use.

WAIVERS & CONSENT

I acknowledge the risks associated with participation and release SOS Ensemble from liability.

I agree that my child will adhere to the Code of Conduct.

I consent to my child’s participation in rehearsals, events, and performances.

I agree to return any issued uniforms or equipment in good condition.

Gender

Male Female

Ethnicity

Hispanic or Latino Non-Hispanic or Latino

Households Info Section: List all household members and their relationship to you.

Complete this section for age eligible membership(s) ages 5-14 (Children of specialized population are between the ages of 5 and 17). 5 year old(s) must provide proof that they are currently attending or have completed VPK.

Please upload the required documents

Attachments for Application

Copy of Proof of Palm Beach County Residency (Ex. recent utility bill, school demographics with camper’s name and address, driver’s license, etc.)
Copy of Photo ID (Upload one of the following: Driver's License, US Passport, Resident Card, Work Permit)

Note: The file format must be a .pdf, .docx, .doc, .dotx, .xls, .xlsx, .xltx, .jpg, .jpeg, .png, .bmp, .tif.

Note: ELC Camper(s) are not eligible for scholarship and system will not allow you to enter the camper(s).

Handbook Acceptance

I agree to the Rules and Regulations within this Handbook.

Auxiliary Membership ( 4 Person )

Auxiliary Membership ( 3 Person )

Auxiliary Membership ( 2 Person )

Band Membership ( 4 Person )

Band Membership ( 3 Person )

Auxiliary Membership ( 1 Person )

REGISTRATION

Attachments for Application