SPRING 2018
REGISTRATION APPLICATION

This registration application must be completed online prior to the SCVYO scheduled enrollment dates

All Enrollment Fees are payable in person on date of Audition/Registration

**Please complete a separate Registration form for each student.

STUDENT INFORMATION
Student Name *
Student Name
Use drop down menu to select
Date of Birth *
Date of Birth
Student Cell
Student Cell
PARENT/GUARDIAN INFORMATION
Parent/Guardian *
Parent/Guardian
Address *
Address
Parent Cell *
Parent Cell
Parent Home *
Parent Home
Emergency Contact *
Emergency Contact
Please provide an emergency contact other than parent/guardian completing this application.
Emergency Cell *
Emergency Cell
Emergency Home *
Emergency Home
Volunteers help us with our on-going endeavor to bring quality music education and performance opportunities to the youth of our community. Please share your special skills and talents with us. Pick Two from the following drop-down menu:
STUDENT SCHOOL & MUSICAL EDUCATION
School attending for the 2017-2018 academic year
What grade will student be enrolled in August 2017 - June 2018. Use drop down menu to select.
AUDITION REQUIREMENTS
You must submit an audition application and $25 non-refundable audition processing fee. Your appointment will be scheduled once these materials are received. Who Needs to Audition: *All new musicians to the SCVYO must audition *All returning members of Symphony of the Canyons must audition each Fall to continue participation in SOC. Returning Symphony members may also participate in the Concerto Competition during your Symphony Audition. *All returning members wanting to join an additional ensemble (example: Chamber Music, Guitar, Adv. Brass) *All returning members wanting to move up to the next ensemble level *All returning Orchestra members wishing to Chair Challenge **Musicians may audition and/or enroll in more than one ensemble. Placement is strictly at the discretion of our music directors at the time of audition
Use Drop Down Menu:
Use drop down menu to select
All students have the opportunity to audition for our Annual Concerto Competition, held during the Fall semester. Student must be prepared to play, at a minimum, the Exposition of the selected movement, as well as the standard Symphony audition requirements. Student should bring 3 additional copies of the concerto sheet music for the audition panel. Winner of the concerto competition will perform their piece accompanied by Symphony of the Canyons in the Santa Clarita Performing Arts Center during the Fall season. I would like to audition for the Symphony Concerto Competition. Use drop down menu to select
Use drop down menu to select
School Music Teacher
School Music Teacher
PRIVATE TEACHER INFORMATION
Please note that all students should have a private instructor in addition to their school music teacher. Please contact us if you need referrals.
Private Teacher Name
Private Teacher Name
Private Teacher Phone
Private Teacher Phone
Use drop down menu to select
Please indicate the primary SCVYO ensemble student was enrolled in during the Spring 2017 semester. Use drop down menu to select.
How many semesters has student participated in Symphony of the Canyons (Advanced Orchestral Ensemble) PRIOR to this enrollment? Use drop down menu to select
CHILD'S HEALTH INFORMATION
Name on Insurance Card *
Name on Insurance Card
e.g., Anthem Blue Cross, Kaiser, etc.
Insurance Phone
Insurance Phone
Primary Physician *
Primary Physician
Physician Phone *
Physician Phone
Immunizations Current? *
Please use the drop down menu to indicate if your child has any of the listed health issues? If "NONE" please select "NONE" on the drop down list. Use the blank box below to describe medical concerns and treatment (eg, food or environmental allergies, etc). Use drop down menu to select
1. eg: allergy, reaction, symptoms, treatment Please type "NONE" if there are no health/psychiataric concerns.
Would you like to order your child a SCVYO tee shirt? *
We strongly encourage you to order a tee-shirt for your child. There are opportunities for community performances when we ask our young musicians to wear their SCVYO tee-shirt. $15 each payable at registration. Use drop down menu to select size.
Use drop down menu to select
Type None if not applicable
WAIVER OF LIABILITY & PHOTO RELEASE
Waiver & Photo Release *
I understand that the above-named activity, sponsored by the SCVYO Foundation, involves physical activity, and that accidents can occur during the above-named activity, and that participants in this or any physical activity can suffer serious injury or death. I further understand that while SCVYO Staff and the SCVYO Foundation Volunteer Leaders may be trained in basic first aid and CPR, they are not medical professionals and are not trained to diagnose, monitor or treat chronic or acute medical conditions, whether preexisting or caused by participation in the above-named activity. Nevertheless, I, AS THE PARENT/LEGAL GUARDIAN, OF THE ABOVE-MENTIONED MINOR (hereafter “Minor”) AND FOR MYSELF, HEREBY ASSUME THESE RISKS OF PARTICIPATING IN THE ABOVE-MENTIONED SPECIAL EVENT. In return for allowing Minor to participate, I, on behalf of Minor and for myself, hereby waive, release, and discharge any and all claims for damages for personal injury, disability, death, or property damage of any kind which may hereafter accrue to Minor or myself as a result of his/her participation in this activity. This release is expressly intended to discharge in advance the SCVYO Foundation and its employees, agents, and volunteers from and against any and all liability arising out of or connected in any way with Minor’s participation in this activity. THIS WAIVER AND RELEASE WILL APPLY EVEN THOUGH LIABILITY MAY ARISE OUT OF NEGLIGENCE OR CARELESSNESS ON THE PART OF THOSE DISCHARGED INCLUDING THEIR EMPLOYEES, AGENTS, AND VOLUNTEERS, AND INCLUDING GROSS NEGLIGENCE TO THE EXTENT THAT CALIFORNIA LAW PERMITS SUCH WAIVER AND RELEASE. This Waiver and Liability Release shall apply to Minor and myself, as well as any of our heirs, executors, or administrators. I hereby certify that I am the parent or legal guardian of Minor and that I am acting in that capacity. Further, I acknowledge that I have read this document and understand its contents. For the Parent/Guardian: By submission of this waiver of liability, I acknowledge that the SCVYO Foundation sponsors the above-named activity and realize that NO MEDICAL INSURANCE IS PROVIDED. I, the parent/guardian of the above named Minor, hereby approve his/her participation in the above-mentioned activity. Further, I consent to emergency medical treatment for this minor should the need arise. I expect that the activity supervisors will make an effort to contact me, time permitting, before any treatment other than minor first aid, is administered. PHOTO RELEASE: I hereby grant permission to the employees of the SCVYO Foundation to include pictures and/or video of my child taken during organization activities, in any future brochures or other publicity developed by the SCVYO Foundation or by the media. I understand that the SCVYO Foundation owns the images and videos and I will not receive compensation for the use of the images. I consent to the Waiver of Liability & Photo Release
Notify SCVYO *
I understand in order to complete this application I must email Bess Knight, Executive Director, at info@scvyo.org to confirm my request for an audition appointment.
Today's Date *
Today's Date