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Teupha Day | March 2023
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Teupha Day Registration | March 25th
Student #1
Student Name
Student Email
School Name
Student Grade (Spring 2023)
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Instrument
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Musical Awards/Honors
Private Lesson Teacher (if applicable)
Band Director
T-Shirt Size
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Have You Attended a Teupha Event Before?
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Pertinent Medical Info
Parent/Guardian Name (Primary Contact)
Parent/Guardian Email (Primary Contact)
Parent/Guardian Phone Number (Primary Contact)
Emergency Contact Name
Emergency Contact Relationship
Emergency Contact Phone Number
Student #2
Student Name
School Name
Student Email
Student Grade (Spring 2023)
arrow&v
Instrument
arrow&v
Musical Awards/Honors
Private Lesson Teacher (if applicable)
Band Director
T-Shirt Size
arrow&v
Have You Attended a Teupha Event Before?
arrow&v
Pertinent Medical Info
Parent/Guardian Name (Primary Contact)
Parent/Guardian Email (Primary Contact)
Parent/Guardian Phone Number (Primary Contact)
Emergency Contact Name
Emergency Contact Relationship
Emergency Contact Phone Number
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Media Release Consent Form
I accept the terms & conditions of the
Cancelation/Refund Policy
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Teupha Day Registration (2 Students) - $200
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Thanks for registering for Teupha Day. See you on March 25th!
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