SCHOOL REGISTRATION FORM

Thank you for registering for the Eugene Symphony's Fall Youth Concert. If you have questions or need assistance filling out this form, please contact: Katy Vizdal, Education & Community Engagement Director, katy.vizdal@eugenesymphony.org, 541-687-9487 x1116.

Concert Details
Peter and the Wolf
Tuesday, November 19, 2024
Performances at 10:30 AM & 12:30 PM
Silva Concert Hall, Hult Center for the Performing Arts

Concert Fee:
$5.00 for each student and adult. One chaperone per fifteen students will be admitted for free. Scholarships available upon request.

Payment:
Payment is due by Friday, November 29, 2024. Please make checks payable to "Eugene Symphony Association." You will receive a confirmation email, which will include your invoice amount, shortly after your registration form is received. Schools will be charged for cancellations made less than one week prior to the concert.

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* 1. School Name

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* 2. District Number (eg. Eugene-4J, Springfield-19, Bethel-52)

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* 3. Is your school Title I?

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* 4. Please select the category below that best describes your school:

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* 5. Primary Contact (Name)

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* 6. Contact Position

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* 7. Contact E-mail Address

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* 8. Billing Contact (Name, Title)

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* 9. Billing Contact (E-mail Address)

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* 10. School Mailing Address

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* 11. City

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* 12. Zip Code

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* 13. School Phone Number

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* 14. Grade(s) Attending

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* 15. Select which performance your school will attend:

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* 16. Number of Students Attending

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* 17. Number of Chaperones (Including Teachers) Attending

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* 18. Number of Scholarships Requested (students only)

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* 19. Estimated Number of Buses

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* 20. Please share any special seating accommodations we can provide here: (eg. wheelchair accessibility, preferred seating area in the hall, etc.)

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* 21. How did you find out about this Youth Concert?

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* 22. Please list any additional questions or comments you have here:

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