Youth Chamber Ensembles Registration Step 1 of 4 25% Contact InformationStudent Name(Required) First Last Student Age(Required)12131415161718Parent's Name(Required) First Last Email Address(Required) Address Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific Zip Code Instrument(Required)ViolinViolaCelloString BassPianoYears of Experience on Instrument(Required)123456 or moreSchoolGrade entering fall of this year(Required)101112School Orchestra Director's NamePrivate Instructor's Name Emergency Contact Name(Required)Emergency Phone(Required)Please list and medical conditions or learning disabilities of which we should be awareConsent(Required) I agree and consent.The student or, in the case of a minor, the parent or legal guardian, must assume full responsibility for all personal property while the student is on the premises. The Arkansas Symphony Orchestra cannot assume responsibility for personal property loss or damage or personal injury. Parents of minor students must be attentive to dropping off and picking up their children on time. Faculty and staff will provide no supervision beyond the time limits of the scheduled program. Adult supervision is required any time students are rehearsing in the ASO Stella Boyle Smith Music Center. Parents are responsible for ensemble supervision on non-coaching weeks. Registration in this program is to agree to the terms described within.Parent or Guardian Signature (please type your name)(Required) Your registration is not complete until payment has been received in the ASO office. A payment link will be included in your registration confirmation. Registration closes on June 3rd. The ASO will retain $50 on all cancellations made a minimum of one week prior to the seminar. No-shows and cancellations after June 3rd are not eligible for refunds of any kind. To pay by check, please mail to: Arkansas Symphony Orchestra ATTN: Sonata Seminar PO Box 7328, Little Rock, AR 72217 Please make checks payable to “Arkansas Symphony Orchestra.” To ensure proper credit, please include your child's name in the memo line on the check.LinkedInThis field is for validation purposes and should be left unchanged.