Please fill out this form to enter EMA-YO’s concerto competition EMA Youth Orchestra – Trial Student Name/Nombre del estudiante* First Last Preferred Pronoun/Pronombre preferido*He/HimShe/HerThey/ThemOtherOther Preferred Pronoun Student Email (if applicable)/Correo electrónico del estudiante (si es aplicable) Enter Email Confirm Email Student Cellphone (if applicable)/Móvil del estudiante (si es aplicable)Student Address/Dirección del estudiante* Street Address City State / Province / Region ZIP / Postal Code Is your student Hispanic/Latino? Tu estudiante es hispano/latino? Yes/Sí, Hispanic/Latino No, not Hispanic/Latino Prefer not to answer This information is collected to help EMA with grants and other reporting. Hispanic/Latino ethnicity is a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race. Choose only one.What do you consider your student's racial heritage to be? (Mark any that apply). ¿Cuál considera que es la herencia racial de su estudiante? (Marque cualquiera que corresponda). American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White Prefer Not to Answer This information is collected to help EMA with grants and other reporting. 2022-2023 Grade in School/Grado en la escuela*5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeGraduating Senior2022-2023 School Name/Nombre de la escuela* Which orchestra are you visiting ¿A qué orquesta te estás inscribiendo?*Prelude Orchestra – Mondays 6:00-7:15pmIntermezzo Orchestra – Sundays 5:00-7:00pmSymphony Orchestra – Sundays 6:00-8:00pmWhat instrument do you play? ¿Qué instrumento tocas?*BassoonCelloClarinetFluteEuphoniumFrench HornHarpOboePercussionPianoSaxophoneString BassTromboneTrumpetTubaViolaViolinParent/Guardian Information/Información de los padresParent #1’s Name/Nombre de padre #1* First Last Parent #1’s Email/Correo electrónico de padre #1* Enter Email Confirm Email Parent #1's Cellphone/Móvil de padre #1*Parent #2’s Name/Nombre de padre #2 First Last Parent #2 Cellphone/Móvil de padre #2Parent #2’s Email/Correo electrónico de padre #2 Enter Email Confirm Email Student Health Information/Información de salud del estudianteDoes your student have any physical or diet restrictions? ¿Tiene su estudiante alguna restricción física o dietética?* Yes None Physical or Diet Restrictions/Restricciones físicas o dietéticas:*Does your student have any allergies? ¿Su estudiante tiene alguna alergia?* Yes None Please list student's allergies. Por favor, enumere las alergias del estudiante.*Does your student have any special needs of which staff needs to be aware? ¿Tiene su estudiante alguna necesidad especial que el personal deba conocer?* Yes None Please explain these needs. Explique estas necesidades especiales.*Other information you would like to share? ¿Hay otra información que le gustaría compartir?How did you hear about EMA? ¿Cómo se enteró de la EMA?Saw your location downtownFriendInternet SearchTeacherEMA WebsiteFacebookInstagramEmailSchoolConcertFlyerCurrent or Former EMA StudentOtherI grant permission to be included in Encore Music Academy's promotional materials/media productions. Doy permiso para ser incluido en los materiales promocionales/producciones de medios de Encore Music Academy.* Yes/Sí, I grant my permission No, I do not grant my permission I grant permission to be included in Encore Music Academy’s promotional materials and multi-media productions which may include pictures and/or video/audio recordings on website, social media and in newspapers.By completing this form you agree to the Terms & ConditionsSecurity Question: What is the first letter in Encore? Pregunta de seguridad: ¿Cuál es la primera letra en "Encore"?*
