Paris High School Band 2017-2018

Student name:____________________________________________________________ (Last) (First) (M.I.) Address:________________________________________________________________ (Street) (City) (Zip)

Home phone:_________________ Grade:__________ Birthday:____________________ Mother’s name:_____________________ Father’s name:________________________ Place of Employment:________________ Place of Employment:__________________ Work phone:________________________ Work phone:_________________________

Parent e-mail address:__________________________Cell#:_____________________________

Student e-mail address:_________________________Cell#:_____________________________

Health Information Please Use Ink Only

Insurance Co.:___________________________________ Phone:__________________ Name of Insured:_____________________________ Employer of Insured:_______________________________________________________

please provide applicable numbers: Certificate #:_______________________ Group #:____________________________ Payor #:___________________________ Policy #:____________________________

Does the student have history of: Diabetes Epilepsy Heart trouble Asthma Drug Allergies Other (Explain):____________________________________________________ Regular medications:______________________________________________________

If parents cannot be reached in case of emergency, please contact: Name:________________________________________ Phone:__________________ Physician’s name:_______________________________ Phone:__________________

In the event of injury or serious illness during any Band related trip, I hereby grant permission for a school employee to secure medical services for my child. A licensed nurse or doctor will administer treatment. I agree to accept responsibility for all authorized doctor, hospital & medical expenses incurred on this trip. I understand that I will be notified prior to any medical treatment, if time permits. I have explained to my child the behavior I expect while on Band trips

Parent signature:___________________________________ Date:________________ Student signature:__________________________________ Date:________________

PARIS ISD 139909 FFD STUDENT WELFARE (EXHIBIT) STUDENT INSURANCE

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PARIS INDEPENDENT SCHOOL DISTRICT Consent/Conduct Form

I have discussed the _____Paris High School Band 2017-2018 trips___________ (School trip)

with ___________________________________________________and have given my permission for (Student Name) attendance and participation. I understand and agree that my child will abide by the PISD Student Code of Conduct.

I understand that the students will be chaperoned both en route and during the activity and that normal precautions will be taken in the interest of their safety and well-being. I agree that the sponsors and chaperones will not be held responsible for any accident or misfortune which might occur in connection with this activity and grant permission for medical aid, if necessary.

I also understand that there is accident insurance available through the District with the cost of the premium to be paid by me. In the event I have not heretofore purchased such insurance, the insurance offer is rejected by me and I accept full responsibility for medical costs and other damages of any injury that may result.

Where the singular pronoun I is used herein, it means both parents where applicable.

___________________ ________________________________________________ Date _________________________________________________ Signatures of Parents or Guardian

SPONSOR’S NOTE: You should reproduce this consent and agreement document and have signed copies in your possession for each student attending any non-competitive school-sponsored trip. Forms shall be kept on file until September 1 of the following school year. Date Issued: 6/11/2011 LDU 2011.01 FFD (EXHIBIT)-X

In case of emergency you may call Charles Grissom’s cell phone: 903-249-3745.

I consent to all rules and responsibilities outlined in the Blue Blazes Band Handbook (view online www.parisisd.net/phs) and to the PISD Discipline Management Plan & Student Code of Conduct. I do understand that my child must participate in the NETX Commerce Contest (Sept. 30th), Golden Triangle Classic (Oct. 7th), Pre UIL Contest (Oct. 14th), & UIL Marching Contest (Oct. 17th). I understand that in the event of any severe misconduct my child will be sent home from any Band trip immediately and that it will be at my expense.

Student_____________________________________________ Date________________

Parent/Guardian______________________________________ Date________________

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PARENT/STUDENT UIL MARCHING BANDACKNOWLEDGEMENT FORM

No student may be required to attend practice for marching band for more than eighthours of rehearsal outside the academic school day per calendar week (Sunday throughSaturday). This provision applies to students in all components of the marching band.

On performance days (football games, competitions and other public performances)bands may hold up to one additional hour of warm-up and practice beyond the scheduled warm-up time at the performance site. Multiple performances on the same day do not allow for additional practice and/or warm-up time.

Examples Of Activities Subject To The UIL Marching Band Eight Hour Rule.• Marching Band Rehearsal (Both Full Band And Components)• Any Marching Band Group Instructional Activity• Breaks• Announcements• Debriefing And Viewing Marching Band Videos• Playing Off Marching Band Music• Marching Band Sectionals (Both Director And Student Led)• Clinics For The Marching Band Or Any Of Its Components

The Following Activities Are Not Included In The Eight Hour Time Allotment:• Travel Time To And From Rehearsals And/Or Performances• Rehearsal Set-Up Time• Pep Rallies, Parades And Other Public Performances• Instruction And Practice For Music Activities Other Than Marching Band And Its Components

NOTE: An extensive Q&A for the Eight Hour Rule for Marching Band can befound on the Music Page of the UIL Web Site at: www.uil.utexas.edu

“We have read and understand the Eight-Hour Rule for Marching Band as stated aboveand agree to abide by these regulations.”

Parent Signature_____________________________________Date____________

Student Signature____________________________________Date_____________This form is to be kept on file by the local school district.

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Blue Blazes Band Instrument Information 2017-2018

Instrument you play: *personal *school (Circle one that applies)

1.Marching______________________ Serial #__________________________________ Date checked out:__________ returned:____________

2.Concert________________________ Serial #_________________________________

Date checked out:__________ returned:_____________

3.Jazz___________________________ Serial #_________________________________

Date checked out:__________ returned:_____________

I understand that I am responsible for the security and upkeep of this instrument. I also understand that I will be required to replace or repair this instrument if damage results while the instrument is checked out to me.

Paris Independent School District is not responsible for damage or loss of your personal instrument. It is our recommendation that it be “scheduled” on the parents’ homeowners’ policy. (The coverage is literally “all risk”, there is no deductible, and the premium is not expensive.)

Student:_____________________________________________

Date:______________________

Parent:_______________________________________________

Date:______________________

FED (E)

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