BWS Youth Jazz Registration | Bremerton Symphony

Bremerton WestSound Symphony

Youth Jazz

Youth Ages 10-18

Sundays 5-7 pm
September 11, 2022 - May 21, 2023

North Point Church

1779 NE Hostmark St | Poulsbo WA

Please call or email the symphony office to request scholarship information.

Student Information

Student First Name

Student Last Name

Preferred name or Nickname

Preferred pronouns

Student Phone

Student Email

Student Age

Student Birthdate

Parent/Guardian Information

Parent/Guardian First Name

Parent/Guardian Last Name

Parent Phone

Parent Email

Mailing Address

City

Postal / Zip code

Home Address (if different)

Instrument Information

Primary instrument

# Years played

Teacher

Other instruments played

School Information

School name

City

Grade in fall 2021

Home School? (yes/no)

Emergency Information

Emergeny Contact Name

Emergency Contact Phone

Relationship to Student

Any pertinent medical information or severe allergies? (please list here)

*MEDICAL RELEASE: I (We) the parent(s)/guardian(s) of the above named minor, give my (our) permission for my (our) child to participate in Bremerton WestSound Symphony Youth Jazz Program and assume all risks and hazards incidental thereto, including those arising in the course of transportation to and from Youth Jazz functions. I (We) hereby give consent and authorize proper authorities of Bremerton WestSound Symphony to administer first aid, authorize necessary emergency treatment at a nearby emergency medical facility, and/or authorize a medical doctor to examine or treat the child for illness or injury or both while he/she is in attendance at Youth Jazz or on related activities. By selecting this box you are agreeing to the terms above.

COVID Protocol

Students will not need to provide proof of vaccine to join the BWS Youth Jazz school year program for 2022-2023. Students, whether they are vaccinated or not, who have COVID, show symptoms of COVID, or are exposed to COVID, need to provide negative test results to the music director prior to returning. Please consult with the music director for further clarification. Free tests may be available at: https://sayyescovidhometest.org/

I have read the COVID Protocol

Media Release

Bremerton WestSound Symphony may take photographs, videos, or recordings of Youth Jazz, rehearsals and performances to be used on our website and/or social media accounts, as well as printed materials such as brochures and funding requests. While we will not tag or identify any student, your child's image may be used in these promotional materials in this and future years. No photographs, videos, or recordings will be sold or used for commercial purposes.

I give my permission for the use of any Youth Jazz related photographs, videos, or audio recordings of my child for promotional and social media purposes. By selecting this box you are agreeing to the terms above.

Registration & Tuition

Registration Fee: $75 (non-refundable)

Tuition: $360

Students registering after September 2023 should contact us at info@bremertonsymphony.org

Please make sure to pay the $75 registration fee once registration is completed.
*2021-2022 returning students are exempt from needing to pay the registration fee again
Click here to pay

I recognize that this form is incomplete without also paying the $75 registration fee and will pay/have paid the registration fee

I am a returning student and do not need to pay registration fee again

If you intend to pay via check(s) or cash, email us at info@bremertonsymphony.org

After you register, download the school participation form, complete it, and return by the first day or rehearsal. CLICK HERE TO DOWNLOAD

If you need to pay in installments, choose PayPal at checkout and choose a Pay Later option.

Please click registration button one time only.

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