City & Zip School
Instrument(s) How Long Age Grade
Taking Lessons? Private? Music Teacher’s Name
1. Current Ensemble and Orchestra Involvement (How long?)
2. Past Ensemble and Orchestra Experience (How Long?)
I understand that the
purpose of the orchestra is for adults to work with the youth participants, ages 12 through 18, in
a mentoring and coaching arrangement during the rehearsals. I also understand that the scope of the program arranged
and supervised by Pontiac Bay Symphony Orchestra consists of the scheduled rehearsals, sectionals, and concerts.
Rehearsals are also open to the parents of youth participants. Pontiac Bay Symphony Orchestra has not arranged or
approved any other activities for the orchestra participants beyond the rehearsals and concerts. However, Pontiac Bay
Symphony Orchestra does facilitate phone and email communication among all participants during the course of the
program as a way to communicate orchestra news, information, and activities, and prepare for rehearsals and concerts.
Parent’s Signature Date
Printed Name Contact Phone
Please mail application to: PBSO, P.O. Box 27307, Seattle, WA 98165-1807