Lead Mine Elementary Band

Reserve Your Spot in the Lead Mine Elementary Band!

Please fill out this easy form to register your child for the Lead Mine Elementary School Band.

Parent's Name:
Student's Name:
Grade	3rd grade 4th grade 5th grade
Which band would you like to join?	Beginning Continuing
Home Phone Number:
Cell/Work Phone Number:
Email Address:
Which instrument would your child like to play?

flute clarinet alto saxophone

trumpet trombone percussion (drums AND bells)

Please check if your child would like to borrow a loaner instrument.
FYI - We are out of loaner clarinets and saxophones! :(


Is your child willing to practice his/her band instrument 15 minutes per day, 5 days per week? Yes!



Are you willing to obtain a band instrument, band book and music stand for your child? Yes!



Band tuition is $160 per semester, and we have 3 payment options. Please choose your payment option:

Pay in Full ($160) Pay by the month (Each monthly payment will be $40.) Volunteer once per month, and your tuition is only $125 (You will have the chance to pay on the next page!)

Any Additional Information?