Parent/Guardian first name: :

Parent/Guardian last name: :

Parent/Guardian phone: :

Parent/Guardian mailing address: :

Parent/Guardian city: :

Parent/Guardian zip code: :

Parent/Guardian email: You may provide up to three emails seperated by commas:

Email Authorization:
I authorize the Mt Carmel Music Foundation to email me.
I do not wish to receive email updates from the Mt Carmel Music Foundation.

Emergency Contact Name #1: :

Emergency Phone Number #1: :

Emergency Contact Name #2: :

Emergency Phone Number #2: :

First name: enter your students first name:

Last name: enter your students last or family name:

Group: Band Percussion Orchestra Guard

Instrument/Section: Percussion Orchestra Guard Trumpet Flute Clarinet Saxophone Horn Sousa/Tuba Euphonium Trombone

Grade level:
9th Grade
10th Grade
11th Grade
12th Grade

Does your student have health insurance coverage?:
Yes
No

Insurance Company: :

Name of Insured: :

Policy number: :

Group number: :

Does your student have any Food Allergies or Restrictions: (e.g. Nuts, Vegan, Gluten Free, etc.):

Does your student have any Drug Allergies: (e.g. Asprin, Penicillin, etc.):

Does your student have any Environmental Allergies: (e.g. Bees, Asphalt, Sound, etc.):

Does your student have any Medical or other conditions: (e.g. Diabetes, Asthma, Seizures, Heart Conditions, etc.):

Please select your Music Camp:
Band Camp ($150)
Guard Camp ($225, includes Band Camp and Guard Camp)
Percussion Camp ($325, includes Band Camp and Percussion Camp)
Orchestra Camp ($90)

Please let us know if you are interested in getting involved with our SAT Program:
Maybe, please send me more info
Yes, sign me up!
No, I am not interested

Please select an area of volunteering you would like to get involved with:
Band Mom (help keep the kids stay safe and prepared at Friday football games and weekend tournaments)
Band Dad (move and organize band equipment and push the pit onto the field for Friday football games and weekend tournaments, Moms are welcome too!)
Uniform Mom (prepare, organize, and ensure the fit of all uniforms at Friday football games and weekend tournaments)
Concerts (organize and help at concessions, ticket sales, and setup during concert season)
Corporate Sponsorship (reconnect with our long-term Sponsors in our Annual Sponsorship donations drive, enlist others)
Web work (WordPress, PHP, HTML, Javascript, Database, Copy editing, etc)
Alumni Affairs (help us grow our alumni program, organize alumni events and alumni booth at the tournament)
Help us maintain our storage, equipment, transport, and facilities
Shadow a Senior parent (learn an important skill or job for the foundation or tournament to ensure that knowledge is passed on)
Assist in Fundraising activites
Other (other area, special skill, already volunteering in another capacity, etc.)

Other areas, or special skills you may have: (e.g. Welding, Heavy Lifting, Sewing, Carpentry, etc.):

Please select your donation category:
Band Donation ($650)
Band with Jazz Band Donation ($750)
Fall Guard Donation ($650)
Winter Guard Donation ($650)
Orchestra Donation ($375)
SAT Program Donation (proctor and manage SAT protocol: Oct 1, Nov 5, Dec 3, Mar 11, May 6, Jun 3)
Other consideration

Other consideration: other special case:

Please select your method of payment for your Family Donation:
Pay by Credit Card, single or multiple payments (enter your credit card information on the next page)
Pay by check. Make checks payable to MCMF: PO Box 720188, San Diego, CA 92172-0188. You may give us several post-dated checks.

Number of credit card payments or checks: (enter the number of payments, if you are paying all at once enter '1' here):

First Name:

Last Name:

Email:

Music Camp Payment:

Donation:

Total:

Payment Method:

Manual Total Donation amount: (If you need to change the amount calculated for you then enter it here. For instance if you have two students in the program enter 50% sibling discount on your donation:

Credit card number (if paying by CC): (We do not store your credit card info. We use Authorize.net to transact your credit card payments):

Credit card expiration date: MMYY: