wayne high school marching band · marching band 2019 registration packet welcome to the wayne high...
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WAYNE HIGH SCHOOL MARCHING BAND
2019 REGISTRATION PACKET Welcome to the Wayne High School Marching Band and Warriorettes. The Wayne Band and Warriorettes have a long and proud tradition at Wayne High School. Over the years our marchers have thrilled audiences at football games, parades, and competitions throughout Ohio. It is an experience that will stay with them well beyond their high school years! We are looking for dedicated, hard-working, and talented students to carry on the great traditions of Wayne High School. Interested...We hope so, because without you, there would be no “Wayne High School Marching Band and Warriorettes”. So, we extend to you our most cordial and sincere invitation to join our team!
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BAND and WARRIORETTE CONTACT INFORMATION
Directors and Advisors
Band Directors Kirsten Showers Susan Chambers
233-6431 x. 74136 [email protected]
Percussion Advisor Rick Showers 937-545-7425 [email protected]
Warriorette Advisor Sydney Sweet 937-581-3535 [email protected]
Warriorette Advisor Randi Rhodus 937-479-9587 [email protected]
Facebook Groups Band/Warriorettes
• Wayne Music Club
• Wayne High School Marching Band and Warriorettes
Remind Band/Warriorettes Text @wmbaw
To 81010 See attachment for other options
Twitter Accounts Warriorettes @WHSWarriorettes
WAYNE MUSIC CLUB
The Wayne Music Club (WMC) was established to promote and sustain the various Wayne High School Band programs. The Wayne High School Band programs include Concert Band, Jazz Ensemble, Marching Band, Pep Band, Symphonic Winds, Warriorettes and Wind Ensemble. You will see the WMC leading efforts such as registration, band camp, providing event chaperones, and coordinating numerous fundraisers such as Half Time USA. We also extend to you, proud parents and supporters, an invitation to join our family in support of the Wayne High School Band Programs.
Wayne Music Club Contact Information
President Kristi Mach 937-475-1600 [email protected]
Vice President John Bultman 937-470-7189 [email protected]
Treasurer Dave Hunt 937-789-2827 [email protected]
Administrative Assistant Debbie Burke 937-522-5277 [email protected]
Concession Coordinator Tara Sturgill 937-838-1973 [email protected]
Events Coordinator Tonya Bertorello 937-304-1936 [email protected]
Ways and Means Jennifer Pelsor 937-572-0452 [email protected]
Drumbeat Editor James Burke 937-626-8587 [email protected]
Uniforms Malina Wong 937-545-1482 [email protected]
Equipment Manager Jim Bertorello 937-304-4919 [email protected]
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REGISTRATION PACKET CHECKLIST
MAKE SURE YOUR REGISTRATION PACKET CONTAINS THE FOLLOWING:
Completed Registration Form Completed Emergency Medical Authorization Form Completed Permission for Administration of OVER THE COUNTER Medication Completed Uniform Order Form Completed Summary Form Completed School Instrument Rental Agreement (if applicable) Minimum $75 down payment
Make Checks payable to “Wayne Music Club” Please place students name on the memo line.
WE WILL ACCEPT DEBIT/CREDIT Card Payments on REGISTRATION NIGHT You may pay ALL or just your deposit that night for an additional fee of 3%
THEN:
TURN IN your completed packet and $75 Deposit at Registration Night May 14th for Sophomores/Juniors and May 15th for Seniors/Freshman and 1st year marchers
@ 6:30 P.M. in the Main Gym
OR
MAIL your completed packet and $75 Deposit NOT LATER THAN May 15th Wayne Music Club
P.O Box 24392 Huber Heights, OH 45424
Any registration questions please contact any
Wayne Music Club Board Member prior to registration night.
BALANCE OF PAYMENTS
Second $75 Installment: June 1, 2019
Third $75 Installment: July 1, 2019
FINAL PAYMENT DUE: July 15, 2019
CHECK WRITING POLICY
Checks are payable to “WAYNE MUSIC CLUB”. NOTE: All returned checks will incur a $25 fee in addition to all bank charges. Payment may also be made from existing Student Account. If you wish payment to be taken out of student account, please first check with Student Account Manager to see if your student has an adequate balance, then annotate your Fee Summary Form. If any issues arise, please contact your Director or Advisor immediately.
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TO BE COMPLETED AND TURNED IN
NO LATER THAN July 1!
Physical forms can be found at http://ohsaa.org/medicine/physicalexamform
Print pages 3 and 4 (All other pages are on Final Forms)
Paper Physical Exam Forms 2019-20 Form
Physicians stamp MUST appear next to
physicians’ signature
2019-20 Handbook can be found at http://www.wayneband.com/documents-new
Band Contract can be found on page 27
Warriorette Contract can be found on page 38 Read, Print and Sign Appropriate Contract
TO PARTICIPATE IN BAND CAMP ALL
FORMS MUST BE COMPLETED,
SIGNED, AND TURNED IN!
BAND CAMP IS MANDITORY TO TAKE
PART IN MARCHING BAND!
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REGISTRATION PACKET INSTRUCTIONS
• Registration Form Band and Warriorettes Each band and Warriorette member must complete the registration form and return it as part of your registration packet. This form is required and must be turned in before you may go to band camp.
• Emergency Medical Form Band and Warriorettes Each band and Warriorette member must complete the Emergency Medical form and return it as part of your registration packet. In the unlikely event that your student requires medical attention while at camp, the information on this form will be required by the hospital staff.
• Band Uniform Order Form Band Only Each band member will be issued a full-dress uniform to wear during the season which is provided by the school. There are also required personal items that must be purchased by each band member through the WMC. If you are a returning marcher you may use the items that you have previously purchased if they are in good condition.
• School Instrument Rental Agreement If you are renting an instrument from the school, please pick up a form at registration. The fee for half year is $40.00. The fee for all year is $65.00. If you will be renting more than one instrument during the year, please see Mrs. Chambers for a discount.
• Fee Summary Sheet This will help you calculate your final cost, which includes Band Camp, Uniform Purchase items and Wayne Music Club membership. To make things less of a financial burden, we have all students submit a $75 deposit with their Registration Packet. The balance will then be broken down into two equal payments and are due on the dates shown. Late payments: one day late add $5, one week late, add $10. Any fees still owed three weeks after due-date will be assessed a $25 late fee. NOTE: Participation fees are applicable.
• Registration Packet Checklist This sheet will help you to ensure that you have all required documents, information, and payments which are needed for the season.
• Physical Form Pages Each student must have a physical before they may practice. This can be done through your private physician. You must fill out your portion of the physical form prior to being seen by the doctor. Students with any type of cardiac condition must get signed clearance from their family physician. Students who already have a valid physical form on file with the WHS Athletic Office may obtain a copy of that physical form and submit it with their band registration packet. We are sorry, but we cannot do this for you
• Go Online and Complete Final Forms
A Final Forms link can be located by going to www.wayneband.com Forms to be completed by Band Camp are:
o Lindsay’s Law o Concussion o Yellow Card o Physical o OHSAA Participation Form (2 Pages)
• Keep Pages 1-6 Of This Packet For Your Reference
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REGISTRATION FORM
WAYNE MARCHING BAND
INSTRUCTIONS: Please PRINT all information so it is legible. Complete this form and return it as part
of your registration packet. (Both Band and Warriorette members must complete this form)
Student Name: ___________________________________________________________
Gender: ☐ Male ☐ Female Marching Group: ☐ Band ☐ Warriorette
Instrument/Type: (please specify: alto, tenor, etc) _________________________________
Grade (for 2019-2020 school year): ________________ Birth Date: ___________________
Parent/Guardian Name: _____________________________________________________
Address: _________________________________________________________________
City: _________________________State: _________ ZIP: _______
Home Phone Number: _____- _____ -______
Dad Work: _____- _____ -_______ Mom Work: _______- _______ - ________
Dad Cell: _____- _____ -_______ Mom Cell: _______- _______ - ________
Emergency Contact Person: __________________________________________________
Emergency Home Telephone #: _______ - _______ - _______
Emergency Cell Number #: _______ - _______ - _______
Email Address (Parent): ___________________________@ ________________________
Email Address (Parent): ___________________________@ ________________________
I give my permission for my son/daughter to attend Band Camp and to participate in all band and
Warriorette activities during the 2019-2020 school year. I also give my permission to use any large-
group picture of my student to promote the Band and Warriorettes. Individual pictures or names
will not be used unless the student provides express permission to do so.
Parent/Guardian signature: _____________________________________ Date: _________
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EMERGENCY MEDICAL AUTHORIZATION FORM
Student Name: ________________________ Age: ______ Sex: ____DOB: __________
Address: ______________________________ City: _____________State: ____ ZIP: _______
Primary Contact Name: ______________________________________________
Phone #: _______- _______ - _______ Work #: _______- _______ - _______
Cell #: _______ - _______- _______
Emergency Contact Name ___________________________________________
Phone #: _____ -______ - _______ Cell #: _____ - ______ -_______
Insurance Subscribers Name: (Parent or Guardian Providing Health Insurance)
__________________________________________________________________________
Insurance Subscriber Place of Employment:
__________________________________________________________________________
If you do NOT have insurance there is a form that you will need to fill out and sign for your students file.
Preferred Physician: ___________________________ Phone #: ______ - ______ - _______
Preferred Dentist: _____________________________ Phone #: ______ -_______ - _______
Preferred Hospital: ____________________________ Phone #: ______ - ______ - _______
(Use Reverse Side For More Information if Needed)
Student’s medical history (allergies, drugs, food, etc.):
________________________________________________________________________
________________________________________________________________________
Medications (name, dose, frequency, reason):
________________________________________________________________________
________________________________________________________________________
Physical impairments or conditions to which physician should be alerted:
________________________________________________________________________
________________________________________________________________________
Dietary Restrictions (Vegetarian, etc.)
________________________________________________________________________
________________________________________________________________________
In the event of an emergency, and in the event reasonable attempts to contact a parent, guardian, or other contacts as listed above has been unsuccessful, I hereby consent to the administration of any treatment that is deemed medically necessary by emergency or hospital personnel. This authorization does NOT include major surgery unless it is deemed medically necessary by at least two (2) licensed physicians or dentists. Further, I understand that I will be responsible for all costs associated with the treatment of my student.
Parent’s Signature: _____________________________________________Date: _________
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Parent Permission for Administration of OVER THE COUNTER Medication for Band Events, School Year 2019-2020
Name of Student ______________________________________________________ We (I), the undersigned who are the parent(s)_____, foster parent(s)_____, guardian(s)_____(checkmark the applicable category) of the above named student give our permission for the administration by a member of the school staff of the OVER THE COUNTER (NON-PHYSICIANPRESCRIBED) MEDICATIONS indicated below during any band event, on or off campus. We (I) agree to hold the school district and its employees free from any and all responsibility for the results of such Over-the-Counter medication or the manner in which it is administered, and to indemnify each of them against loss by reason of any civil judgment arising out of these arrangements which may be rendered against them. It is the parent’s responsibility to indicate any ALLERGIES to medications that the student may have.
ALLERGIES: ___________________________________________________ None _____ Please indicate approval/non-approval below for administration of the listed medications only by (1) placing a check mark in the appropriate column, and (2) circling preferred treatment in each category . Dosage will be administered via package directions unless specified otherwise by physician’s orders (must have yellow sheet on file). Generic equivalents may be substituted for brand names.
Ap
pro
ve
Dis
ap
pro
ve
Ailment Treatment
CIRCLE PREFERRED PRODUCT
Headache, menstrual cramps, general minor pain
Acetaminophen (Tylenol), Ibuprofen (Advil/Motrin), Midol orgeneric equivalent Naproxen (Naprosyn)
Sinus/Allergies Sinus Medication (Alavert, Tylenol Sinus, Zyrtec)
Cuts and scrapes Antibiotic ointment, First Aid cream
Cough cough drops
Upset stomach
Antacid tablets, Pepsid, Dramamine or Bonine for motion sickness, Pepto Bismol
Skin rash Benadryl cream, Hydrocortisone cream 1% Zinc Oxide Ointment
Allergic reaction Benadryl (oral) will notify parent if necessary to use
Diarrhea/ Constipation Immodium tablets
Irritated eyes Visine, Saline eye drops
Sprains / strains
Ice, Ace wrap, BenGay Icy Hot, Ointment or generic Equivalent
Insect sting/bite Benadryl cream
I hereby give permission for school personnel to use the above indicated non-prescribed medications and/or treatments for my son/daughter ___________________________________ (student name) while at any on or off campus band event.
Parent Signature_____________________________________ Date_______________ Parent Address_________________________________________________________ Parent Phone # _______________________________________Circle_Cell or Home
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To Be Filled Out At Time of Treatment
Date Time Ailment Treatment
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MARCHING BAND UNIFORM ORDER FORM
STUDENT NAME
Grade in Fall 2019
Instrument/Type (alto, tenor, etc)
Parent/Guardian Name
Phone Number
Email Address
INSTRUCTIONS: Use this form to order New or Replacement Items. Requirements for items have been listed. Fill in Quantity and Size required. REMINDER: All items are being ordered for you personally. You are expected to pay for all items in full, and there will be NO REFUNDS once the order is placed. Orders will be placed once your order sheet and registration deposit has been made. Sample shoes, gloves, and shirts will be available for size verification at registration.
LINE ITEM COMMENTS SIZE COST QTY TOTAL
1
CREW NECK SWEATSHIRT
• Red 50/50 Cotton/Polyester
• Adult Male Sizes S - 3XL
Required for all
Must have a crewneck
OR
a hoodie sweatshirt
$17 each
Add $3 for 2XL
add $4 for 3XL
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HOODIE SWEATSHIRT
• Red 50/50 Cotton/Polyester
• Adult Male Sizes S - 3XL
$21 each
Add $2 for 2XL
add $3 for 3XL
3 SUMMER MARCHING SHIRT
• Adult Male Sizes S - 3XL
Required for all
Seniors excluded
(Must have 2)
$10.00 each
Add $2 for 2XL
$3 for 3XL
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BLACK MARCHING SHOES
• SPECIFY MENS OR
WOMENS SIZE
Required for all
(If unsure of size, order normal
shoe size. Unworn Shoes can be
exchanged)
M:
$30.00
W:
5 Beret (Percussion and Tubas
Only)
Head measurement needed at
registration. $17.00
6 GLOVES
• SIZE S, M, L, XL
Must have at least 2 Pair
Except Percussion & Tubas
$3.00
Each pair
7 DRY CLEANING FEES
-MANDATORY-
Covers 2 cleanings
per season N/A
Dates to be
announced N/A $25.00
8 DUFFEL BAG Optional N/A $31.00
9 NYLON CINCH SACK
Optional N/A $8.00
10 (Add lines 1-9 and transfer total Fee Summary Sheet Line #3) TOTAL COST
REQUIRED SELF-PURCHASE ITEMS
SUMMER SOCKS All Marchers MUST have
White Ankle Length Socks
UNIFORM SOCKS BLACK All Marchers must have
Tall Black Uniform Socks
Black Summer Shorts Docker Style, Not Basketball or Silky
Required for all
Athletic Running Shoes Required for all
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FEE SUMMARY SHEET STUDENT NAME
Grade in Fall 2019
Instrument/Type (alto, tenor, etc)
Parent/Guardian Name
Phone Number
Email Address
LINE # DESCRIPTION COMMENTS TOTAL
1 BAND CAMP FEE ALL MARCHERS $60.00
2 INSTRUMENT USAGE FEE
(FOR THE UPKEEP AND STANDARD MAINTENANCE OF SCHOOL
INSTRUMENT)
$40.00 half year/$65.for full year ANYONE USING A SCHOOL OWNED
INSTRUMENT MUST COMPLETE Rental Agreement
3 PERSONAL UNIFORM
ITEMS (Line #10, Pg. 13)
COMPLETE UNIFORM ORDER FORM AND ENTER TOTAL (Even if not ordering anything,
$25 dry cleaning fee must be added)
4 SENIOR PACKAGE (BAND AND WARRIORETTES
SENIORS ONLY)
Covers senior shirt, Band Camp Senior Party, $35.00 Fee (ENTER ONLY IF APPLICABLE)
5 3rd QUARTER SNACKS Fee to help cover snacks for home games $5.00
6 WAYNE MUSIC CLUB
MEMBERSHIP Membership fee for WMC
($5.00 per family) $5.00
7 PARTICIPATION FEE School fee collected through WMC $150.00
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FEES DUE TOTAL:
If you would like an itemized receipt mailed to you please indicate here: ☐ If mailing this registration packet a receipt will be mailed to you.
NOTE: The balance may be paid in $75 installments due June 1st, July 1st and the remaining balance due July 15th, 2019. Students who are not paid in full will NOT be permitted to attend Band Camp. *** Deposit is non-refundable if registration is cancelled less than 30 days prior to the start of Band Camp. Board use only________________________________________________________________________________________________________
Student Name:
☐ Cash
☐ Check #__________
☐ Credit Card
☐ Money order/ Cashier’s check
#____________
☐ Student account
AMT OWED:
Parent Name: AMT PAID:
Board Signature:
AMT REMAINING:
AMOUNT
TOTAL AMOUNT DUE
From Line #8 above
DEPOSIT*** $75 DEPOSIT DUE TODAY
CASH/CHECK #
CREDIT CARD 3% fee added
STUDENT ACCOUNT
BALANCE DUE AMOUNT DUE BY
JULY 15th, 2019
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Instrument Rental
Fill out the back of this page if you play one of the following instruments and you do not have your own.
Piccolo – with director permission Oboe Bassoon Bass Clarinet Tenor Saxophone Baritone Saxophone French Horn Mellophone Euphonium (Baritone) Marching Baritone Tuba/Sousaphone Percussion
We do not rent: Flute, Clarinet, Alto Sax, Trumpet, Trombone
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Wayne High School Bands
5400 Chambersburg • Huber Heights, Ohio • 45424
Rental Agreement for School-Owned Band Instruments and Equipment
Student Name _______________________________________________________________ Date ________________________
Band Course __________________________________________________________ Graduation Year ____________________
The Wayne High School Band Program wages a rental fee for the use of all school-owned instruments and equipment. This fee is used to maintain and overhaul these instruments based upon normal student use.
Rental Agreement Conditions:
1. I hereby request rental of a school-owned instrument at the rate of ______ $40.00 (1 semester) ______ $65.00 (all year)
2. I agree to keep the instrument cleaned and in good playing condition. 3. I assume full responsibility for proper care and handling of the instrument. 4. The Wayne Band Program assumes the responsibility for maintenance of the instrument resulting from normal use, excluding
negligent treatment by the renter. 5. I am responsible for paying the cost of repairs if there is damage beyond normal wear and tear as determined by the band directors. 6. I agree that no person other than the above named student will be allowed to use the instrument at any time unless that student has
also completed a rental agreement contract. 7. I agree to return the instrument upon request, without refund of the rental fee, if satisfactory effort and progress on behalf of the
student is not maintained as determined by band staff. 8. I understand that the rental of an instrument may be limited to one year and is not necessarily guaranteed for future years.
Please sign this agreement and return, along with the rental fee, to your band director no later than __________________.
Please make checks payable to Wayne Music Club and note “Instrument Rental Fee” on the check.
Signature of Parent/Guardian __________________________________________________________ Date _________________ Address ___________________________________________________________________ Home Phone __________________ City _____________________________________________________________ State ____________ Zip __________________
Instrument Information: Instrument Use:
Instrument Type
Make Model
Serial Number
Condition when issued
Mouthpiece/Accessories
___________ ___________ Date Issued Director Initial
___________ ___________ Date Fee Paid Director Initial
Cash___ Check___ Check No. _______
_____ Concert Bands _____ Marching Band
_____Jazz Ensemble _____ Pep Band
_____ Summer Use _____ Other
Return Information: _____________ _____________
Date Returned Director Initial
Condition when returned
Accessories Returned
Damages attributed to the student: