The Orchestra Rocks Youth Concert Registration

1.

Thank you for using the online registration form for the Eugene Symphony's The Orchestra Rocks Elementary Youth Concert.

Concert Details
Date: Tuesday, February 17, 2015
10:30 - 11:20 am; 12:30 - 1:20 pm
Silva Concert Hall, Hult Center for the Performing Arts
*All numbers, including attendance and scholarship, must be confirmed by noon on Friday, February 13, 2015.

A supplemental teacher packet will be provided for those not participating in Link Up by Monday, January 12.

Fee: $5.00 for each student and adult. One chaperone per fifteen students will be admitted for free. Scholarships are available (there is not an application process).

Payment: Payment is due by Friday, February 27. 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: http://eugenesymphony.org/education/grants-and-advocacy/

Question Title

* 1. School Name/Family Member's Name:

Question Title

* 2. District Number:

Question Title

* 3. Contact Person:

Question Title

* 4. Contact Position:

Question Title

* 5. Contact E-mail Address:

Question Title

* 6. School/Family Mailing Address:

Question Title

* 7. City:

Question Title

* 8. Zip Code:

Question Title

* 9. School/Family Phone Number:

Question Title

* 10. Grade(s) Attending:

Question Title

* 11. Which performance will your school be attending?

10:30-11:20 a.m.

12:30-1:20 p.m.

Question Title

* 12. Number of Students Attending (changes will be accepted through Wednesday, February 11, 2015):

Question Title

* 13. Number of Chaperones Attending (one chaperone per fifteen students will be admitted for free):

Question Title

* 14. Number of Scholarships Requested (changes will be accepted through Wednesday, February 11, 2015):

The Orchestra Rocks Youth Concert Registration

1.

Question Title

* 1. School Name/Family Member's Name:

Question Title

* 2. District Number:

Question Title

* 3. Contact Person:

Question Title

* 4. Contact Position:

Question Title

* 5. Contact E-mail Address:

Question Title

* 6. School/Family Mailing Address:

Question Title

* 7. City:

Question Title

* 8. Zip Code:

Question Title

* 9. School/Family Phone Number:

Question Title

* 10. Grade(s) Attending:

Question Title

* 11. Which performance will your school be attending?

Question Title

* 12. Number of Students Attending (changes will be accepted through Wednesday, February 11, 2015):

Question Title

* 13. Number of Chaperones Attending (one chaperone per fifteen students will be admitted for free):

Question Title

* 14. Number of Scholarships Requested (changes will be accepted through Wednesday, February 11, 2015):

Question Title

* 15. Number of Wheelchairs:

Question Title

* 16. Estimated Number of Buses:

Question Title

* 17. Special Seating Needs (Other Than Wheelchairs):