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Jul 29, 2016 ... Welcome new and returning parents, if you have a band student, you ... this packet and more can be found on the THMS Marching 100 website at ... please feel free to contact one of the Band Booster board members with any.
WELCOME 2016 – 2017 MARCHING 100 BAND MEMBERS & PARENTS

GO BADGERS! Dear Band Booster Parents/Guardians: Welcome new and returning parents, if you have a band student, you are a THMS Band Booster! What is THMS Band Boosters? The THMS Band Boosters are a 501c3 non-profit organization dedicated to providing support and “boosting’ the band program at Tucson High Magnet School. How do the THMS Band Boosters support the Marching 100? Parents/Guardians are able to support the THMS band program through volunteering, fundraisers and band operation pledges. Through these efforts students are provided many different kinds of support for the home and away functions including meals, transportation, music, equipment, uniform management, awards and many other essentials necessary for our students in band. All band parents are invited to the first Band Booster Parent Meeting of the 2016-2017 school year Friday, July 29th, 2016 at 6:00pm in the THMS cafeteria. We expect all parents to come to this event to learn more about the Marching 100 season and the opportunities for becoming an involved Band Booster Parent! In addition, freshman and new parents can join us for a short tour of all important band landmarks at THMS during band camp placements on Sunday, July 24th at 6:00pm. What is in this packet? This letter contains important Marching 100 information for you and your student. Please review this information with your student carefully. Please complete and bring all of these forms contained within this packet to the first day of band camp on July 24th, 2016. 1. Student Registration 2. Band Pledge Financial Information 3. Band Pledge Payment Voucher 4. Rehearsal and Performance Schedule 5. Student Commitment Contract 6. Band Camp Information 7. Band Uniform Information 8. Band Booster Volunteer Opportunities 9. THMS Band Media Form 10. Tax Credit Donation Information 11. Permission to Treat Minor Medical Form 12. THMS Interscholastic/Fine Arts Packet Two special opportunities: Families that turn in their band operations pledge of $160.00 on or before August 12th, 2016 will receive a free 2016-2017 student show T-shirt! These show shirts are normally priced at $15.00 and are required attire for the 2016-2017 marching season. The Band Boosters will also have a payment plan option for the band operations pledge. The pledge can be split into three payments – (1) payment of $60 and (2) payments of $50 each. These payments will be due July 29 ($60), August 26 ($50) and September 30 ($50). All payments can be made via Pay Pal on the band website or via check turned into the band office safe.

Where can I find THMS Band Information? All the information in this packet and more can be found on the THMS Marching 100 website at www.tucsonhighbands.org. Be sure to check it frequently for updates on rehearsals, performances, volunteer opportunities, payments and much more! THMS Band Boosters General Email: [email protected] In addition to this general email, please feel free to contact one of the Band Booster board members with any questions or concerns you may have. We will be glad to help in any way we can! What about after the Marching season? Traditionally every other year the Marching 100 travels to perform out of state. We are currently researching a trip to Universal Studios; the cost is anticipated to be between $500 and $700 per student. The boosters will continue to provide updates on this possible trip. Sincerely, Tucson High Magnet School Band Booster Board Ernesto Denogean, President

[email protected]

Kerry Hodgkinson, VP of Volunteers & Membership

[email protected]

Sylvi Gonzalez, VP of Concessions

[email protected]

Volunteer Needed, Treasurer Stephanie Hamilton, Secretary

[email protected]

Tammy Myers, Uniform Supervisor

[email protected]

Jules O’Herron, Past Booster President

[email protected]

REGISTRATION & FINANCIAL INFORMATION Full band registration packets must be completed even if fees are not paid at the time of registration. It is important that we have this information in case of an emergency and to have contact information for students and their parents. The students and parents must also sign the commitment contract. There will be an opportunity for all parents to talk with band representatives and register their students. Students will be given AIA forms during the full school registration when they pick up their schedules. We have included copies of these forms in this packet for you to fill out and return to us. This form must be completed for students to travel or compete with the band. An AIA fee will be required during registration. Financial assistance options are available to families including payment plans, Badger Foundation grants and scholarships from the Tucson High Band Boosters. There are a limited number available. If you are interested in a payment plan or scholarship with the Band Boosters, please contact Band Boosters at [email protected] or you may speak with someone at the Registration/New Parent Orientation on July 29, 2016, 6:00pm. If you would like to submit a request to the Tucson High Badger foundation, you can also pick up a form in the library or visit their website at http://www.BadgerFoundation.org/ for more information. It’s going to be a great season! All this information and more can be found on the band’s website at tucsonhighbands.org. Be sure to check it frequently for any changes in schedule or for fun.

TUCSON HIGH MAGNET SCHOOL MARCHING 100 2016 – 2017

Student Information

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Please complete this form and return it OR complete this information online. Please complete only one time and submit on or before the first day of Band Camp, July 24th. The marching band registration form and operations pledge can be submitted during the Band Booster Parent Meeting/Orientation on July 29, 2016, 6:00pm in the THMS Cafeteria. PLEASE MAKE CHECKS PAYABLE TO: THMS Band Boosters Student Name ____________________________________________________________________________ Grade ____________________________

Returning Band Member ______Yes ______No

Instrument(s)/Guard _______________________________________________________________________ Parent/Guardian Name(s) ___________________________________________________________________ Address _____________________________________________________________Zip Code ____________ Home Phone __________________ Cell Phone __________________ Work Phone _____________________ Parent/Guardian Email _____________________________________________________________________ Student Email ____________________________________________________________________________ Student Cell Phone ________________________________________________________________________ If your family has more than one band student, please complete the following for the second student: Student Name ____________________________________________________________________________ Grade ___________________________

Returning Band Member ______Yes _____No

Instrument(s)/Guard _______________________________________________________________________ Student Email ____________________________________________________________________________ Student Cell Phone ________________________________________________________________________ Parent Volunteer information: Please list below any special talent or area of expertise you have that you would like to volunteer to share with the Band Boosters (e.g. carpentry, cooking, sewing, financials, decorating, crafting, typing, photography, etc.).

You can complete these forms online, order shirts and shoes, as well as pay for your fees, by using your credit card or checking account through Pay Pal at www.tucsonhighbands.org.

TUCSON HIGH MAGNET SCHOOL MARCHING 100

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2016 – 2017

Uniform Costs and Band Operations Pledge Student’s Name

_______________________________________________________________

Band Operations Pledge

Number of Students

Pledge Total

$160 per student, $260 per Family

$__________

Marching & Color guard Shoes

Size

$35

Men’s Size:

MANDATORY for Freshman

Women’s Size:

Qty

Shoes Total $__________

Returning Band Members: Not needed if shoes are still in good condition and fit from previous years. Some previously used shoes have been donated from seniors and are available on a “first come” basis. Please check with uniform supervisor when you are being fitted for your uniform. Student Band Polo

Size

$25

Men’s Size:

MANDATORY for Freshman

Women’s Size

Qty

Polo Total $__________

Returning Band Members: Not needed if already have one from previous years and in good condition. Some gently used shirts from graduating Seniors are available on a “first come” basis. Please check with the uniform supervisor with questions. Unisex sizes run large  S-XXXL. ($2 more for XXL and larger) Student Show T-Shirts

Size

Qty

$15

T-Shirt Total $__________

MANDATORY for all Marching 100 Members Parents and family members can order them too! Unisex sizes run large  S-XXXL. ($2 more for XXL and larger) BONUS: Get your student’s show shirt fee by paying your family operations pledge by August 12 th, 2016. SUBTOTAL FOR STUDENT EXPENSES OPTIONAL ITEMS

$____________ Size

Qty

Total

Parent Show T-Shirt $15 S – XXXL ($2 more for XXL & larger)

$__________

Parent polo Shirt $25 Unisex sizes run large. S – XXXL ($2 more for XXL & larger)

$__________

Volunteer Opt Out Contribution $60/minimum per student Parent volunteer participation is an expected and essential part of a successful band season. If you are not able to help the band as a volunteer, you have the option making a volunteer opt out contribution to support our activities.

$__________

TOTAL FOR MARCHING 100 EXPENSES Please make checks payable to “THMS Band Boosters” Thank you!!

$____________

The Band/Guard Fees are assessed by the Band Boosters on every student who participates in the Tucson High Marching 100. Fees pay for the band expenses that are not covered by the school, TUSD or through fund raising efforts. Please do not hesitate to contact us should you need assistance paying your fees. Please contact the [email protected] Financial assistance is available through the Educational Enrichment Foundation or the Tucson High Badger Foundation by contacting the THMS Financial Office.

TUCSON HIGH MAGNET SCHOOL MARCHING 100 2016 – 2017

Band Operations Pledge Payment Plan Voucher July 29 ($60)

August 26 ($50)

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September 30 ($50)

Date: _______________________ Student Name: ____________________________________________ Email Address: _________________________________________________________________________ Amount Paid $: ____________________

(Circle One) Cash

Check

Money Order

TUCSON HIGH MAGNET SCHOOL MARCHING 100 2016 – 2017

Band Operations Pledge Payment Plan Voucher July 29 ($60)

August 26 ($50)

September 30 ($50)

Date: _______________________ Student Name: ____________________________________________ Email Address: _________________________________________________________________________ Amount Paid $: ____________________

(Circle One) Cash

Check

Money Order

TUCSON HIGH MAGNET SCHOOL MARCHING 100 2016 – 2017

Band Operations Pledge Payment Plan Voucher July 29 ($60)

August 26 ($50)

September 30 ($50)

Date: _______________________ Student Name: ____________________________________________ Email Address: _________________________________________________________________________ Amount Paid $: ____________________

(Circle One) Cash

Check

Money Order

TUCSON HIGH MAGNET SCHOOL MARCHING 100 2016 – 2017

Rehearsal and Performance Commitments

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2016 - 2017 Band Camp (See attached detailed schedule): July 12th – 15th: Percussion/Color Guard Camp  9am to 3pm July 17th – 20th: FJM Camp in Flagstaff (Open to leadership plus interested student who pay their own way) July 20th – 29th: Full Band Camp  7:30am to 5pm July 29th: Band Camp Performance  7pm in stadium 2016 Full Event & Rehearsal Schedule:

2017 Full Event & Rehearsal Schedule:

August 9th- First evening band rehearsal  6pm – 9pm

January 11th- Fine Arts Assembly Performance

August 16th- Rehearsal  6pm – 9pm

January 27th & 28th- Regional Auditions

August 19th- HOME Game vs. Buena

February 17th & 18th- Regional Festival

August 23rd- Rehearsal  6pm – 9pm

February 23rd- Rodeo Parade

August 26th- AWAY game (Marching 100 NOT attending)

May 12th- Spring Band Concert

th

August 4 - School Starts

August 30th- Rehearsal  6pm – 9pm September 2nd- HOME Game vs. Desert Ridge September 6th- Rehearsal  6pm – 9pm September 9th- AWAY Game vs. Salpointe September 13th- Rehearsal  6pm – 9pm September 16th- HOME game vs. Mountain View September 20th- Rehearsal  6pm – 9pm

TBA Dates coming soon: Parade of Lights Eller Events Band Banquet

September 23rd- AWAY game at Cienega September 27th- Rehearsal  6pm – 9pm September 30th- bi-week (possible practice on field)

Weekly Rehearsal Schedule:

October 5th- Rehearsal  6pm – 9pm

HOME Football Fridays 3:30 4:30PM, meal break, uniforms, Concert Arcs @ 6:15, Pregame @ 6:45 Kickoff @ 7PM. Most games are over by 9:30PM. Band is released following uniform return.

October 7th- HOME game vs. Sunnyside (start of FALL break) October 11th- Rehearsal  6pm – 9pm October 14th- HOME game vs. Ironwood Ridge (possible Senior night) October 18th- Rehearsal  6pm – 9pm October 21st- AWAY game vs. Rincon (LAST game) October 22nd- U of A Band Day October 25th- Rehearsal  6pm – 9pm October 26th- THMS Magnet Open House Performance

AWAY football games will require load-out, uniforms and travel from 3:15 to 5:00PM. Typical pick-up time @ THMS following an AWAY game is between 10:30 and 11:00PM.

October 29th- Ironwood Ridge Marching Festival November 5th- State Marching Festival th

November 11 - Veteran’s Day Parade December 19th- Winter band concert rehearsal afterschool December 20th- Winder Band Concert

For up-to-the-minute schedule updates, see the Tucson High Bands Facebook page or Booster Blast emails!

TUCSON HIGH MAGNET SCHOOL MARCHING 100 2016 – 2017

Marching Band Commitment Contract Student Name: ______________________________________

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Matric #: ________________

I have read and understand the 2016 -2017 Marching 100 Rehearsal and Performance Schedule sheet. I have reviewed this detailed schedule with my parents/guardians and made the appropriate arrangements for each date. Although the band follows school policy for excused medical absences, members of the Marching 100 are encouraged to make every possible effort to attend the complete schedule of rehearsals and performances. I also understand that membership in the Marching 100 requires me to be academically responsible. I understand that it is my responsibility to know where I stand in each of my classes, and to seek help if my grades start to decline. In addition, membership in Marching 100 requires me to be behaviorally responsible. I understand that it is my responsibility to demonstrate exemplary behavior at all times as a Marching 100 member. I have read and understood the TUSD Athletic/Activities Code of Conduct and understand the behavioral expectations and violation consequences. Band is not a convenience… it is an opportunity. Throughout the season, section-leaders and captains will periodically call for sectional rehearsal outside of the regular practice schedule. These will not exceed one per week. I understand that it is my responsibility to make every possible effort to attend these sectional rehearsals. After reviewing the schedule with my parents/guardians, the following are pre-existing schedule conflicts that are extremely important and completely unavoidable that I am unable to resolve for the 2016 - 2017 Marching Season:

With the exception of the conflicts listed above, I hereby commit myself to the 2016 - 2017 Tucson High Marching 100 for the duration of the season. If other unavoidable conflicts come up after completing this form please contact Mrs. Huestis at [email protected] By signing below I hereby commit myself to:    

2016 - 2017 Marching 100 rehearsal and performance schedule Being academically responsible Being behaviorally responsible Adhering to the performance dress code of the Marching 100

Student Signature: _____________________________________ Date: ___________

Parent Signature: _____________________________________

Date: ___________

TUCSON HIGH MAGNET SCHOOL MARCHING 100 2016 – 2017

Band Camp Information

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Band Camps will be held at Tucson High July 12th – 15th July 24

th

July 24th th

th

July 25 – 29

9am to 3pm

Percussion and Guard Camp

5:30pm to 8:30pm

Winds and Brass Placement

6:00pm

Freshman/New Parent Tour (Meet in breezeway)

7:30am to 5:00pm

Full Day Band Camp

th

5:15pm – 6:00pm

Band Member Dinner

July 29th

6:00pm – 6:50pm

Band Booster Meeting

7:00pm

Skill Demonstration and Performance

July 29 July 29

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Important Reminders: ALL band and guard members are expected to attend band camp. If you cannot attend due to an extremely important and completely unavoidable conflict please contact Mrs. Huestis at ([email protected]). PRE-HYDRATE! Be sure to drink plenty of water the day and night before band camp. It’s just as important as keeping hydrated during rehearsal. Pack a large water bottle, sports drink, and a healthy snack. EAT A GOOD BREAKFAST! You will be marching for at least 4 hours per day. Bring: your music, instrument, mouthpieces, extra reeds, valve oil, drumsticks or anything else you might need to be a successful musician. Bring: a sack lunch or lunch money each day of band camp. Box lunches will be available ranging in price for $3. Gatorade and snacks are available for purchase in addition to lunch. Since band camp is a school function, students are expected to stay on campus during lunch and breaks. Possible Daily Menu - items will be served with chips or fruit, bottled water and dessert  Ham sandwich  Pizza  Grilled cheese  Turkey sandwich  Hot dog A specific daily menu and order forms will be available at band camp registration. Wear: Your band shirt, which you will get on Sunday, and comfortable, cool clothing, a hat and sunscreen In addition, supportive sneaker-type athletic shoes for marching (no flip-flops or sandals). Medications: Bring your inhaler if you have asthma or other necessary medications for any other conditions. Check them in with the band camp nurse. Arrival: Don’t be late for report times! To be early is to be on time, to be on time is to be late.

TUCSON HIGH MAGNET SCHOOL MARCHING 100 2016 – 2017

Uniform Information page

      

Marching Band Uniform Marching jacket (provided) Marching pants (provided) Hat/Beret (provided) Gloves (FIRST pair provided) Show T-shirt Long black socks (NO print or design) Marching shoes

     

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Color Guard Uniform Show dress or top (provided) Black tights (provided) Nude supportive bra Nude support body suit Guard shoes Flag(s) (provided)

Marching band gloves will be distributed the first time the students wear their uniform. Students who lose gloves can replace them for a $3.00 fee. Please see uniform parent for details. Band members must purchase a show t-shirt, long black socks with no designs and marching shoes Guard members must purchase a show t-shirt, nude supportive bra, nude support body suit and guard shoes. Color Guard members must be pay by July 12th, to ensure uniforms are ordered. Show t-shirts are designed to reflect the show music being played for that year. Show t-shirts are required to be worn underneath the uniforms. The shirts are $15 and can be ordered during registration or at any time. Be aware that before every performance the uniform supervision will be checking to ensure that all performers have proper uniform components, including the correct show shirt. If a student does not have the correct show shirt they may be required to purchase one at that time. Tucson High band red polo shirts are required for all Marching 100 band and guard members. These shirts are $25 and can be ordered during the registration process or purchased at any time. Students will wear these polo shirts with khaki pants as a uniform for events that do not require the full marching band uniform. No eating at any time while wearing your marching band uniform. You may drink water only while wearing the uniform. There may be times when the band director will give students permission to remove their jacket to eat or drink. It is recommended that during these times students do not sit to ensure nothing is spilled on the uniform pants.

TUCSON HIGH MAGNET SCHOOL MARCHING 100 2016 – 2017

Band Booster Volunteer Information

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Volunteering with the TMHS Band Boosters is fun! Volunteering is a great way to get to know the band member and their families! Band Parents/Guardians are asked to volunteer a minimum of 4 hours of time during the season. There are a variety of ways you can help. Please see the list of volunteer opportunities below. Please contact Volunteer Coordinator, Kerry Hodgkinson, if you want to volunteer or for more information. [email protected] STANDS SUPERVISION LEADER: Position Open  Arrive early to football game  Proceed to the football field to check in as a volunteer (Free admission!)  Fill and transport water containers + cups to the stands  Sit with the band and maintain student decorum  Give students water  Provide trash bags to band members at the end of game for trash pick up  Check to ensure band members have left the stands clean  Great way to get to know all the band members! CONCESSION STAND: LEADER: Sylvi Gonzalez Fun, high energy, busy job; bond with other parents and to meet all the home team and visitor supporters. 3 POSITIONS – PREPARATION:  Arrive early to help set up  Proceed to the football field to check in as a volunteer (Free admission!)  Set up concession stand, drinks and non-perishable food  Prepare food (assemble, grill or microwave) 3 POSITIONS – GAME SALES, 1ST HALF  Arrive 30 minutes before the game  Proceed to the football field to check in as a volunteer (Free admission!)  Assist with set up  Assemble drink and food orders  Assist cashier as needed (Only adults may cashier) POSITION 3 – GAME SALES, 2nd HALF:  Arrive 15 minutes before half-time  Proceed to the football field to check in as a volunteer (Free admission!)  Assemble drink and food orders  Assist cashier as needed (Only adults may cashier)  Assist with clean up BUS CHAPERONE LEADER: Position Open  Ride on bus to/from away games and competitions  Assist TUSD/band staff member with maintaining discipline  Free transportation to band events  Get to know kids and band staff  Watch and be amazed

TRUCK UNLOADING AND LOADING LEADER: Position Open  Assist with loading/unloading the equipment truck for away games and events  Group leader will manage the loading and unloading process  Equipment includes percussion instruments, tubas, conducting stands and uniform racks  At away games and competitions, push percussion equipment from staging area along field track, possibly over graveled areas, and into place on the field  Watch the performance from the front lines  Build upper body strength  Ride on hydraulic ramp – Woo hoo! DRIVE RENTAL EQUIPMENT TRUCK LEADER: Position Open  Free transportation to band events  Drive equipment truck and help load/unload as above  Must have current driver’s license and experience driving a large vehicle STUDENT CARE CREW LEADER: Tammy Myers  Bring snacks for after games and competitions  Help students as needed  Care for students who are not feeling well (overheated, headache, dehydrated, etc.).  Indulge your desire to nurture and feel good about it  Wow us with your best cookie or other snack recipe! SOCIAL EVENTS LEADER: Position Open  Plana and coordinate senior night  Plan and coordinate end of year banquet  Plan and coordinate any other Band Booster sponsored social events  Create and decorate  Have fun with menu planning, setting up, cleaning up BAKING BRIGADE LEADER: Position Open  Organize the baked good sale at the band concerts  Arrive before band concert to set up tables and water  Recruit bakers for delicious baked goodies  Cashier  Clean up FUNDRAISING LEADER: Position Open  Develop creative ways to raise funds for the Marching 100  Get to know parents and local businesses  Help plan and carry out fundraising campaigns and sales (Examples: selling Eegees, car wash, street fair parking, cookie dough sales, etc.) VOLUNTEERS LEADER: Kerry Hodgkinson  Assist with recruiting and organizing volunteers  Help make phone calls or send e-mail reminders  Thank and recognize our awesome volunteers at end of year banquet

TUCSON HIGH MAGNET SCHOOL MARCHING 100

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2016 – 2017

Band Media Permission Form

I hereby give permission to TUCSON HIGH MARCHING BAND/THMS BAND BOOSTERS to post photographs and or videos of my son/daughter, Student Name: ______________________________________ on the TUSD, Tucson High Magnet School, THMS Band Booster Website and/or Facebook site(s) for an indefinite amount of time. My son/daughter and I waive and release any claim arising from these photographs.

________________________________________

____________________

Signature of Parent or Guardian

Date

TUSD Parent Permission Form Interscholastic/Extracurricular Programs I hereby give permission to TUCSON HIGH MAGNET SCHOOL to post photographs of my son/daughter___________________________ on the school’s and/or TUSD Interscholastic Internet website for an indefinite amount of time. My son/daughter and I shall forever waive and release any claim he/she and I may have against the school and TUSD arising from the photographs whether known or unknown, and shall hold TUSD and any successor or successors in interest harmless from the same.

______________________________________ Signature of Parent or Guardian

__________________ Date

TUCSON HIGH MAGNET SCHOOL MARCHING 100 2016 – 2017

Tax Credit Donations

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The Tucson High Marching band is in need of tax credit donations. These donations are used to provide instruments, sheet music, competition travel expenses, and a variety of other needs to support the musical education for hundreds of Tucson High Magnet School band students. Studies have shown that kids who are involved in extracurricular activities have a better grade point average and are less likely to drop-out of school or get involved with drugs. You can help us by encouraging your family, friends, neighbors, and co-workers to donate their Arizona Tax Credit to the THMS Bands. The State of Arizona authorizes a tax credit up to $400 for income tax payers filing jointly and a $200 credit for individuals. When you file your state taxes in 2017, your total tax for 2016 will be reduced by the amount that you donate. This means it costs you nothing and the students benefit from your generosity. Please consult your tax professional for more information. If you have not already contributed your tax credit funds, please consider donating to the Tucson High School Bands. If you have already made your contribution, whether to the band or another entity, please encourage others to support our cause. They do not have to have school age children to contribute. We welcome ANY amount that will help defray the costs of the programs to our students. You can even make payments in any amount during the year. If you would like to contribute, it’s easy! Go to TUSD1.org and click on the blue box in the upper right hand corner that says GIVE KIDS THE EXTRA CREDIT. This will link you to a page where you can: Select school – Tucson Magnet HS Select Activity – Band Select an Amount $

Thank you for your support!

TUCSON HIGH MAGNET SCHOOL MARCHING 100 2016 – 2017

Booster Consent Form for Minor Medical Treatment

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Part 1: Emergency Consent Information (please provide emergency numbers) Student Name: ______________________________________________ Phone: _______________________ Parent/Guardian Name: _______________________________________ Phone: _______________________ Parent/Guardian Name: _______________________________________ Phone: _______________________ In the event I/we cannot be reached, please contact: Name: ________________________________ Phone: _________________ Relationship: _______________ Name: ________________________________ Phone: _________________ Relationship: _______________ Our family physician is: __________________________________________ Phone: ____________________ Our hospital of choice is: _________________________________________ Our health insurance is: _____________________________________ Group ID: ______________________ Member ID: _______________________________ Customer Service Phone: __________________________ In the event that my/our child should require medical attention and/or hospital care and I/we cannot be reached I/we hereby authorize the band director to act on our behalf and authorize medical care for my child on my/our behalf until we can be reached. Parent/Guardian Signature: ___________________________________

Date: ________________________

Part 2: Medical Information Medical Conditions: _______________________________________________________________________ ________________________________________________________________________________________ Any associated medication student is currently taking: ____________________________________________ Any rescue medication student requires having on their person: _____________________________________ ________________________________________________________________________________________

Medicine allergies: ______________________________________ Reaction: __________________________ Medicine allergies: ______________________________________ Reaction: __________________________ Food allergies: _________________________________________ Reaction: __________________________ Food allergies: _________________________________________ Reaction: __________________________ If necessary I/we consent for my/our student to wear a disposable medical alert during transportation in order to remind staff and booster nurse of allergies which might constitute an emergency. Parent/Guardian Signature: ___________________________________

Date: ________________________

Part 3: Permission for Medicine I give permission to administer the following during 2016 – 2017 band camp and marching season, if needed, as directed by designated booster band nurse. Sunscreen: ________

Acetaminophen (Tylenol): ________

Antacid (Tums): ________ Pepto-Bismol: ________

Ibuprofen (Advil): _________

Loratadine (Claritin): _________

Diphenhydramine (Benedryl): _________

Parent/Guardian Signature: ___________________________________

Best Contact Phone: ________________________________

Date: ________________________

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