Spirit of Great Oak Band & Guard

Member Information

Member Name: ______________________________________       Grade: ___________

Instrument:__________________________ T-Shirt Size: __________________

Live with:  Both Parents _____     Mom _____     Dad_____     Guardian ______

Address__________________________________ City ___________________

Zip_______________  Phone ________________________________________

Father’s Name: ___________________________________________________

Phone __________________  Email __________________________________

Mother’s Name: ___________________________________________________

Phone __________________  Email __________________________________

Guardian’s Name: _________________________________________________

Phone __________________  Email __________________________________

Signature ___________________________    Date________________