BWS Youth Jazz Registration | Bremerton Symphony

Bremerton WestSound Symphony

Youth Jazz

Youth Ages 10-18

Registration Form Due by September 6, 2022

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.

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 due by first rehearsal

Tuition: $360

Students registering after September 2021, should select Other

Select a tuition payment schedule

Full Payment (Due 9/26/2021)

Two Payments (Due 9/26/2021 and 1/30/2022)

Monthly Payments (Monthly payments beginning 9/26/2021)

Other (arrange with office)

I will pay the REGISTRATION FEE on or before the first day of Youth Jazz rehearsal. Please send check payments to Bremerton WestSound Symphony, PO Box 996, Bremerton, WA 98337CLICK HERE TO PAY REGISTRATION & TUITION

I will pay full TUITION as marked above by the agreed upon dates or will call the symphony office if I need to make arrangements.CLICK HERE TO PAY REGISTRATION & TUITION

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

Please click registration button one time only.

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