BHS Eagle Band Forms Packet 2014-15 - broomfieldbands.orgbroomfieldbands.org/.../Band-Forms-Packet-2018-19.docx · Web viewIf you want Marching Band Updates to be sent to other

2018-2019 Broomfield High SchoolBand Student Information Form

____ Student’s Last Name Student’s First Name

____ Student’s Home Address City Zip

____ Student’s Cell Phone (optional) Student’s Email (optional)

_________ Mother’s Name (or primary guardian) Address if different than Student

____ Mother’s Primary Phone Mother’s Email

_____ __________ Father’s Name (or primary guardian) Address if different than Student

_____ Father’s Primary Phone Father’s Email

Student lives with: Both parents Mother only Father only Guardian

Marching Instrument Concert Instrument Guard

2018 - 19 Grade in school: 9th 10th 11th 12th

If you want Marching Band Updates to be sent to other family members, please include name/s and emails:____________________________________________________________________________

____________________________________________________________________________

The above information is kept confidential and used expressly for band purposes.

BHS Band Forms Packet Page 1 of 18

Please return all forms to Mr. Romero

by Tuesday, September 4!

Boulder Valley School DistrictAthletic Registration/Emergency Information

Student Name ___________________________________________ ( M F ) Grade ___________

Marching Band: _____ Winter Percussion: _____ Winter Guard: _____

Parent Name _________________________________________________________________ Address _______________________________ City ____________________ Zip ________ Home Phone _____________________ D.O.B. ___________________ Age _______

Father’s Work Phone ___________________ Mother’s Work Phone _________________

Father’s Cell Phone ____________________ Mother’s Cell Phone _________________ School Attended Last Year ______________________ Grade ___________________ Name of Insurance Company: ___________________ Group/ID# __________________

** List two LOCAL people who will temporarily care for your student if you cannot be reached:

During the School Day After School Hours

1. Name______________________________

Phone________________________________

2. Name______________________________

Phone________________________________

3. Name______________________________

Phone________________________________

4. Name______________________________

Phone________________________________

HEALTH INFORMATION: List any significant or on-going health conditions relevant to school or athletics (severe allergies/EpiPen, asthma, A.D.D., birth defect, diabetes, epilepsy, heart disease, vision or hearing problem, medications, etc.). I hereby give my consent for medical treatment deemed necessary by physicians for any illness or injury resulting from his/her athletic participation. I understand this authorization will only be enforced when I cannot personally be contacted and provide for immediate treatment.

PLEASE LIST IN THIS SPACE

_________________________________________________ ___________________


PARENT/GUARDIAN SIGNATURE Date


Broomfield High School Band ProgramsPhoto/Contact Release2018-19 School Year

Student Name:

____ Yes, I give permission to Broomfield High School (BHS) and Broomfield Band Parents

Association (BBPA) for my son/daughter to be photographed while engaged in BHS band activities

throughout the year. This may include rehearsals, performances, competitions, or special activities

for Marching Band/Color Guard, Concert Band, Pep Band, Winter Guard, Winter Percussion, and

Jazz Band. These photos may be used for school promotional purposes and/or media stories.

____ No, I do not give permission for photos of my son/daughter to be used for promotional purposes

during BHS band activities.


CONSENT TO RELEASE HEALTHCARE INFORMATION

I, _________________________________________, hereby authorize the Boulder Center for Sports Medicine Certified Athletic Trainer to:

_____ (Please initial) disclose information regarding potential injuries sustained by my student athlete with his/her coach and/or teacher. Any information disclosed to the respective coach and/or teacher will be used to modify athletic participation for the safety of your student athlete.

_____ (Please initial) NOT disclose information regarding potential injuries sustained by my student athlete with his/her coach or teacher. _____________________________________________ Name of Parent/Guardian (printed) _____________________________________________ Signature of Parent/Guardian Date _____________________________________________ Name of Student Athlete (printed)

This consent is good for the duration of the school year, unless I rescind my permission in writing to the Boulder Center for Sports Medicine at 311 Mapleton Avenue, Boulder, CO 80304.

CONSENT FOR TREATMENT Marching Band: _____ Winter Percussion: _____ Winter Guard: _____

I understand that my son/daughter ___________________________________ (Print name of student) may be injured while participating in school sponsored athletics. I hereby grant permission to the team physician and Certified Athletic Trainer to administer any preventative, first aid or emergency treatments that they deem reasonably necessary to the health and well-being of my student athlete. I understand the Certified Athletic Trainer may offer my student advice concerning nutrition, hydration and conditioning. The Certified Athletic Trainer may also provide my student with hot or cold packs, wound care, taping, massage, ultrasound, electrical stimulation, whirlpool treatment and therapeutic exercise.

Please use this form to list• any medications your student athlete takes on a regular basis• any food or medication allergies• any medical conditions that we need to be aware of in order to properly care for your

son or daughter Name of Parents: __________________________ Signature of Parent: ____________________________ (please print) Mother’s Home #: ___________________ Mother’s Cell #: ___________________________ Father’s Home #: ___________________ Father’s Cell #: _____________________________

Medications:

Allergies:

Medical Conditions:


BVSD ATHLETIC INSURANCE WAIVERHigh School

I understand that the Boulder Valley School District does not provide accident insurance for any student participating in school sports or any other school activity. American Youth Insurance Company offers a school time or 24-hour (12 month) type of insurance which will provide accident coverage for Middle Level and Senior High School Sports.

CHECK ONE: _____ I have purchased one of the accident insurance plans offered by American Youth Insurance

OR _____ I have other accident insurance coverage

OR _____ I do not have insurance and I will assume responsibility for payment of expenses incurred in the

event of injury to my son/daughter. Date: ___________ Signed: ________________________________________________________

(student)

Signed: __________________________________________________________________________ (parent/guardian)

RESPECT PLEDGEColorado High School Activities Association (CHSAA)

All people in our community need to know that respect is a lifetime value taught through inter-scholastic activities; it is a principle of good citizenship. By taking this pledge, a person chooses to accept the responsibility for his or her actions, whether as a participant or spectator.

Why do we need to demonstrate respect for each other?

1. To decrease the emphasis on winning or losing. 2. To promote ethics and integrity in all walks of life. 3. To learn the attitudes necessary for responsible behavior. 4. Respect is about the relationships – not the game.

The CHSAA Student Participant Respect Pledge(to be read and signed by the student)

I, _________________________________________________, will focus my actions as a student participant on respecting my opponents, coaches, sponsors, parents, fans and officials. I believe that by demonstrating respect for all people involved in my activity, I am a catalyst for positive interaction among participants in interscholastic activities and athletics. By taking this pledge, I accept the responsibility of serving as a role model for all students in my community.

Student signature Date

The CHSAA Spectator Respect Pledge(to be read and signed by the parent)

I, ___________________________________________, will focus my actions as a spectator of high school athletics and activities on respecting all participants, coaches, sponsors, and officials. I believe that by demonstrating respect for all people involved in activity, I am a catalyst for positive interaction among


participants and fans of interscholastic activities and athletics. By taking this pledge, I accept the responsibility of serving as a role model for all members of my community.

Parent signature Date


School ____________________ PLEASE RETURN THIS FORM BY ______________ Destination ___________________ Date (s) of trip activity ____________________ Teacher ____________________

BOULDER VALLEY Public School STUDENT TRAVEL

FIELD TRIP PERMISSION FORM I hereby permit ________________________________________________________________ to participate in __________________________________________________________________________________________ (describe trip/activity) (dates(s)) He/She will be transported by: Fee required _____________ School Bus __________________ *Sack Lunch (see below) Private car __________________ Walking __________________ Transportation if the responsibility of the parent _______________ Other ______________________ (specify)

1. I understand that the Field Trip/Activity may take place away form school property; may involve transportation by school bus, private vehicle, common caries or other mode of transportation; and may involve activities beyond the scope of traditional school functions conducted on School district property.

2. I understand that the Field trip/Activity may involve activities beyond the scope of traditional school

functions. I acknowledge that my student’s participation in the activities potentially involves risks and obligations that are impossible to predict, by may include the risk of loss or damage to personal property and the risk of sickness, personal injury or death.

3. I understand that the School District does not purchase, or have, any medical, dental or hospitalization

insurance to cover injuries to or loss of life of students or to indemnify parents and guardians for expenses in connection therewith, and that such insurance, if desired, must be purchased by me.

____________________________ _________________________________ (Date) Signature of Parent or Guardian TO BE USED FOR LOCAL AND METRO AREA SHORT TRIPS. THIS FORM IS TO BE COMPLETED BY STAFF AND SUBMITTED TO PARENT/GUARDIAN FOR SIGNATURE. *If you would like the school to make a sack lunch for your child, fill out the form below and return this signed permission slip to the classroom teacher. Your child’s lunch account will be charged the price they normally pay for school lunches. --------------------------------------------Teacher tear off and send to office------------------------------------------------ Yes, make a sack lunch for: Child’s Name ________________________ Teacher _________________________ Date of Trip _________ BHS Band Forms Packet Page 8 of 18

PLEASE RETURN THIS FORM BY September 4, 2018 School BHS Required by BVSD for all Marching Band Students Destination Various MB Activities

Date(s) of trip Activity Aug 2018 – May 2019Teacher Mr. Ruben Romero



BHS Marching Band2018 – 2019 Cost and Fair Share Program

Like other extracurricular activities including other arts programs and sports, there is a cost to participate in all band programs (marching band, color guard, etc.). The BBPA is able to offset the cost of the band program by fundraising throughout the year.

Participation in and the success of BHS Eagle Band programs depends on participation in fundraising activities and a cash obligation.

Monetary Obligation

The band is fully funded by band fees and donations. Total cost or Full share per student is $500. The cost pays for additional instructors, competition fees, transportation, instrument repairs, uniform upkeep, etc. The Full share amount can be reduced to the Fair Share cost of $300 if parents participate in all/most of the band and fundraising activities and/or additional volunteer opportunities for BBPA.

Fundraising ParticipationAll students are required to participate in Tag Day, selling Raffle Tickets, selling Applebee’s Breakfast tickets, and the Mattress Fundraiser, etc.

Some of the fundraisers include:

Tag Day fundraiser (Fall) Raffle fundraiser (Fall) Concessions (Fall)

Scrip fundraiser (All Year) Mattress fundraiser (Early 2018) Restaurant Nights (Monthly)

Board Members Chair Volunteer Positions

Tag Day – Direct solicitation of funds by students as they go door-to-door throughout Broomfield in marching band or guard uniforms. Students leave flyers or “tags” in doors when people aren’t home. Students are placed in groups and accompanied by an adult volunteer, from 9am-4pm on a Saturday, in October. Parent volunteers are a must to make the day successful.

Raffle – Raffle of cash and prizes. Each student is expected to sell a minimum of 10 tickets and help staff sales events at local businesses (i.e. King Soopers, Safeway, etc.). Parent volunteers are needed to supervise students at the events.

SCRIP – Gift card purchases that can be used for purchases that are already being made, such as gas, groceries, eating out, and clothing. No additional cost to purchase.

Concession Stand – One adult per family will need to work at the Band Stand (located on the south side of the Football Field) during football games, soccer games, and track meets (if needed).

Restaurant nights – attend with your families and friends; help spread the word. (Bi-Monthly)

If you opt out of the above fundraisers, you will need to pay the full $500 for your student.PAYMENT is due in full by September 4, 2018.Optional payment plan: Full or Fair share divided by 3; due the FIRST DAY of Sept., Oct. and Nov.

Please make your check(s) payable to BBPA and give to Mr. Romero, BBPA Treasurer or Deputy Treasurer; or mail them to BBPA, PO Box 951, Broomfield CO 80038.Credit Card Payment: Pay by credit card at https://squareup.com/store/broomfield-high-school-band-parents-association. There will be a $12.00-$20.00 Processing fee for every transaction.


Students; 60%

BBPA Fundrais-ing; 40%

BVSDStudentsBBPA Fundraising

https://squareup.com/store/broomfield-high-school-band-parents-association


Cost and Fair Share Program - Promissory Note ______ (Please initial) I understand that my family and my participation in supporting our financial fair share is essential to the operation of the Band and Guard Programs. I understand that money earned during fundraising activities that I participate in will be

used for these programs. I understand that the fundraising money may not be earmarked for my student (unless otherwise stated on the agreement) but will be used to fund the program for all students that participate. ______ (Please initial) I agree to meet my financial obligation. I understand that I will be charged the full share, but the amount can be reduced by volunteering in the various fundraisers. If my family volunteers at ALL, the fundraisers the cost will be reduced to $300 fair share. I have also read and understand the Broomfield High School Band policies contained in the member handbook (www.broomfieldbands.org). I agree to submit payments as defined by the band program my student is participating in, by delivering personally to BBPA Treasurer or Deputy Treasurer or by mailing to the BBPA mailing address at PO Box 951, Broomfield, CO 80038 or by credit card (Including a processing fee) to https://squareup.com/store/broomfield-high-school-band-parents-association.

______ (Please initial) I agree that a late fee of $10 will be added to my account for each payment that is late. I further agree that check fee of $10 will be added to my account for each check that is returned for insufficient funds to the BBPA. I further agree that I am responsible for obligations represented by this promissory note.

______ (Please initial) I understand that no refunds will be made to students after October 1, 2018.

NOTE: The BBPA will make every effort to keep its members informed of the expenses incurred in these band programs and will track them according to the original member approved budgets. Budgets projected on student participation numbers may be adjusted once those numbers have solidified. Any budget increases will require additional approval by the BBPA general membership. Expense reductions to meet financial fair share projections may be taken as necessary by approval of the officers of the BBPA.

Student name Parent name

______ (Please initial) I have read and understand the 2018-2019 BBPA Cost and Fair Share obligations.

Please select Full Share or Fair Share (checks are payable to BBPA):

I will pay $500 for the full cost for my student in one payment by September 4, 2018.

I will be charged the Full Cost and will commit to fulfill our (Parents and Student) financial and volunteer obligations associated with the 2018-19 band season and receive fee reductions to lower the full share. The final amount will be decided by my volunteer commitments. The minimum for fair share is $300 per student. Payment is due by September 4, 2018.

☐ I will pay by credit card online at https://squareup.com/store/broomfield-high-school-band-parents-association by September 4, 2018. I am aware there will be a $12.00-$20.00 processing fee included with each transaction.

☐ I would like to split my payment into 3 installments due in September 1, October 1, and November 1.

☐ Donation: I will fulfill my Fair/Full Share responsibilities and would also like to donate $ to the BHS band program.

I agree to pay Full Share if I do not fulfill my Fair Share responsibilities.


https://squareup.com/store/broomfield-high-school-band-parents-association%20by%20September

https://squareup.com/store/broomfield-high-school-band-parents-association%20by%20September


Parent Signature Student Signature


Student Name

BBPA PROGRAMS JACKET PURCHASE AGREEMENT 2018-2019

Band Jackets are mandatory for all public performances every year for every band member including Guard. You can purchase a jacket (or you can use last year’s if you’ve already purchased one).

Thoroughly read the purchase agreement below. This form must be signed by both a parent/guardian and the student and returned by September 4, 2018.

Purchase Cost for Jacket: $45

______I understand Marching Band students are required to purchase a band jacket and the cost is $45.

I have a jacket of my own from a previous year ($0)

Parent/Guardian signature: ______________________________________ Date: _____________________

Student name (please print): ________________________________________________________________

Student signature: _____________________________________________ Date: _____________________

Please PRINT CLEARLY the personalization requested: __________________________________________

Jacket size: ___________ (XS, S, M, L, XL, XXL, XXXL)

Payable by Cash or Check. Checks are payable to BBPA.

- - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

For BBPA treasurer use only: Paid by cash __________ or check __________ (check # __________)

Approved by Mrs. Ginger Ramsey



Student Name

BBPA PROGRAMS SHOE PURCHASE AGREEMENT 2018-2019

Band Shoes are mandatory for all public performances every year for band members excluding Guard. You can purchase a pair of shoes (or you can use last year’s shoes if you’ve already purchased them).

Thoroughly read the shoe purchase agreement below. This form must be signed by both a parent/guardian and the student and returned by September 4, 2018.

Purchase Cost: $30

I have read, understood and agree to the terms and conditions of the BBPA Shoe Purchase Agreement form.

I intend to purchase shoes ($30) OR

I have shoes of my own from a previous year ($0)

I am in guard and do not require marching shoes.


Student name (please print):


Shoe size: ___________ (Please include shoe size) Women’s or men’s (Please circle one)

Checks are payable to BBPA

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - -

For BBPA treasurer use only:

Paid by cash __________ or check __________ (check # __________)


Competition Meals Agreement

Competition days are long days. The BBPA likes to provide meals to each student, instructor and volunteer of Broomfield High School Band. We have five competitions scheduled for the 2018 Marching Band Season. We are requiring each student’s family to contribute $5.00 for each competition for a total of $25.00.

We are aware that several students have food allergies or food restrictions. Please share these restrictions with us and if necessary some ideas on what foods they can eat. We will do our best to include food choices, so everyone will be well fed.

Allergies: _________________________________________________________________________________

Food Restrictions: __________________________________________________________________________

Helpful Ideas:

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

5 Meal @ $5.00 Each: $25

______I understand Marching Band students are required to contribute $5.00 per competition for the 2018 Marching Band season for a total of $25.00


Student name (please print): ________________________________________________________________


Payable by Cash or Check. Checks are payable to BBPA.

- - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - BHS Band Forms Packet Page 17 of 18

For BBPA treasurer use only: Paid by cash __________ or check __________ (check # __________)

Show Shirt Order

Every year, the Marching Band has a new show shirt that the students wear to every competition, football game and many band events. Each student will receive a shirt with the cost of their band fees.

To show our support for our students and the band, parents, family members and friends have the opportunity to purchase a show shirt for the 2018 season to wear at all band events.

____ Yes, I would like to order one or more show shirt for the 2018 Marching Band Season.

Size Crew or Long Sleeve


Documents

BHS Eagle Band Forms Packet 2014-15 - broomfieldbands.orgbroomfieldbands.org/.../Band-Forms-Packet-2018-19.docx · Web viewIf you want Marching Band Updates to be sent to other