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Thank you for using the online registration form for the Eugene Symphony's Musical Time Machine Elementary Youth Concert.

Concert Details
Date: Tuesday, November 14, 2016
10:30 - 11:15 am & 12:30 - 1:15 pm
Silva Concert Hall, Hult Center for the Performing Arts

A supplemental teacher packet will be available in Fall 2017 on the Eugene Symphony website here!

Fee: $5.00 for each student and adult. One chaperone per fifteen students will be admitted for free. Scholarships are available.

Payment: Payment is due by Friday, November 21. Please make checks payable to Eugene Symphony. You will receive a confirmation email, which will include your payment amount, shortly after your registration form is received. Schools will be charged for cancellations made less than one week prior to the concert.

Please visit our website for a list of grants available to help fund youth concert costs.

School Name

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* 1. School Name

District Number

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* 2. District Number

Contact Person

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* 3. Contact Person

Contact Position

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* 4. Contact Position

Contact E-mail Address

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* 5. Contact E-mail Address

School Mailing Address

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* 6. School Mailing Address

City

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* 7. City

Zip Code

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* 8. Zip Code

School Phone Number

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* 9. School Phone Number

Grade(s) Attending

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* 10. Grade(s) Attending

Which performance will your school be attending?

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* 11. Which performance will your school be attending?

Number of Students Attending

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* 12. Number of Students Attending

Number of Chaperones Attending

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* 13. Number of Chaperones Attending

Number of Scholarships Requested

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* 14. Number of Scholarships Requested

Number of Wheelchairs

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* 15. Number of Wheelchairs

Estimated Number of Buses

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* 16. Estimated Number of Buses

Special Seating Needs (Other Than Wheelchairs)

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* 17. Special Seating Needs (Other Than Wheelchairs)

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