Registration for OSMP

Student Information
Student Name *
Student Name
Home Phone *
Home Phone
Address *
Address
Birthdate *
Birthdate
Father's Information
Father's Name
Father's Name
Father's Address
Father's Address
(if different from student)
Father's Phone
Father's Phone
Mother's Information
Mother's Name
Mother's Name
Mother's Address
Mother's Address
(if different from student)
Mother's Phone
Mother's Phone
Agreements
Photo Release Agreement *
I am the parent or legal guardian of the listed child registrant who is under 18 years of age, and as noted above I hereby give permission for photographs or video of the child being registered to be published on the website of the Oshkosh Suzuki Music Program or used for other purposes related to the Oshkosh Suzuki Music Program such as media advertising and brochures.