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Student & Family Information Form

2020-2021 Firebird Band Programs - Chaparral High School
Student Information
Student Name *

First Name Last Name
Preferred Name / Nickname
Student's Preferred Name
Gender *

Male Female
Student Address *

Street Address

Street Address Line 2

City State

ZIP Code
Grade Level *

Freshman / 9th Sophomore / 10th Junior / 11th Senior / 12th
Graduation Year *
This field has been auto-filled; you do not need to edit the entry.
Is your student a Section Leader or on the Band Council? *

Yes No
Which band(s) will your student participate in? *

Marching Band Concert Band Jazz Band
Marching Instrument *
Concert Instrument *
Parent / Guardian (#1) Information
Name *

First Name Last Name
E-mail *
Please include your updated email address as most correspondence is sent via email.
Phone Number *

Area Code Phone Number
Remind Text

I do NOT want to receive important info and updates from the Boosters via Remind text.
Alternate Phone Number

Area Code Phone Number
Address *

Same as Student Different
Address *

Street Address

Street Address Line 2

City State

Zip Code
Add second parent / guardian information? *

Yes No
Parent / Guardian (#2) Information
Name *

First Name Last Name
E-mail *
Please include your updated email address as most correspondence is sent via email.
Phone Number *

Area Code Phone Number
Remind Text

I do NOT want to receive important info and updates from the Boosters via Remind text.
Alternate Phone Number

Area Code Phone Number
Address *

Same as Student Different
Address *

Street Address

Street Address Line 2

City State

Zip Code
Add an additional emergency contact? *

Yes No
Emergency Contact Information
Name *

First Name Last Name
E-mail *
Please include your updated email address as most correspondence is sent via email.
Phone Number *

Area Code Phone Number
Alternate Phone Number

Area Code Phone Number
Relation to Student *
Relation to Student *
Address *

Same as Student Different
Address *

Street Address

Street Address Line 2

City State

Zip Code
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Student & Family Information Form

Student Information

Parent / Guardian (#1) Information

Parent / Guardian (#2) Information

Emergency Contact Information