Membership Application - EPSYO | El Paso Symphony Youth Orchestras

EPSYO MEMBERSHIP APPLICATION 25-26

HIGH IMPORTANCE: Before submitting your EPSYO application, read it over a second time to check for incomplete information & most common spelling errors. Please make sure your EPSYO application is being submitted error free, all tabs must be filled out and correctly answered to avoid any delays in your application process.

STUDENT APPLICATION

STUDENT STATUS

Please select only one option from each dropdown menu. Should one of these options not apply to you, please select “Not Applicable” to avoid confusion. Thank you! Move up auditions will only be granted to previous students who have not yet been placed into an orchestra for the 2025-2026 season.

1) I am a new EPSYO applicant OR require an audition for the 2024-2025 season.(Required)

Please select only one option from the dropdown menu to avoid confusion.

2) I am a returning EPSYO member from the 2024-2025 season & wish to audition for a more advanced ensemble.(Required)

Please select only one option from the dropdown menu to avoid confusion.

3) I am a returning EPSYO member from the 2023-2024 season and wish to continue in my current ensemble.(Required)

Please select only one option from the dropdown menu to avoid confusion. This option does not require an audition.

STUDENT INFORMATION

Student's Name (Follow Name Order: Last Name + First Name)(Required)

Last, First

Please fill out FULL STUDENT'S NAME, if incomplete you will be required to re-submit your entire EPSYO application.

Student's Birthday (MM/DD/YYYY)(Required)

Student's Full Address (Number, Street, City, State, Zip Code) Example: 103 Apple St. El Paso, TX 79912(Required)

Full street address

Please fill out complete address, if incomplete you will be required to re-submit your ENTIRE EPSYO application.

Student's Phone Number (Area code + Number) (Example: 915-111-1234)(Required)

*Only used to contact student in case of an emergency during rehearsal.

Student's Email(Required)

*Not Parents email

SCHOOL INFORMATION

*Attending during 2025-2026 school year

Student's School(Required)

Student's Grade(Required)

School District(Required)

Will you be graduating from High School in 2025?(Required)

Yes

Expected High School graduation year?(Required)

Musical Background

*Students who only play piano or saxophone should call the EPSYO office at (915) 525-8978 for availability before applying.

Musical Instrument(Required)

Instrument Experience(Required)

Less Than One Year

1 Year

2 Years

3 Years or More

Are you currently enrolled in a Music Program?(Required)

School Orchestra Program

School Band Program

Private Music Instructor

None of the above

Were you referred by a Music Teacher? (If yes, please type full teacher's name in the corresponding box below.)(Required)

My School Music Teacher referred me to EPSYO. (Only type the name of the school teacher who referred you; if not, type N/A)

My Private Music Teacher referred me to EPSYO. (Only type the full name of the private teacher who referred you; if not, type N/A)

PARENT/GUARDIAN INFORMATION

Mother’s Name or Legal Guardian’s Name (Follow Name Order: Last Name + First Name)(Required)

Last, First

Please fill out FULL PARENTS NAME, if incomplete you will be required to re-submit your entire EPSYO application.

Mother’s Primary Email(Required)

Mother’s Primary Phone Number (Area code + Number) (Example: 915-111-1234)(Required)

Area Code + Number

Mother’s Address (if different from Student's)

Full Street Address

Please fill out complete address if necessary, if incomplete you will be required to re-submit your ENTIRE EPSYO application.

Father’s Name or Legal Guardian’s Name (Follow Name Order: Last Name + First Name)(Required)

Last, First

Please fill out FULL PARENTS NAME, if incomplete you will be required to re-submit your entire EPSYO application.

Father’s Primary Email(Required)

Father’s Primary Phone Number (Area code + Number) (Example: 915-111-1234)(Required)

Area Code + Number

Father’s Address (Only if different from Student's)

Full Street Address

Please fill out complete address if necessary, if incomplete you will be required to re-submit your ENTIRE EPSYO application.

HOW DID YOU HEAR ABOUT THE EPSYO?

Please select at least one box:(Required)

Friend in EPSYO

Poster/Flyer

School Visit from EPSYO Staff

EPSYO Website, Facebook, Twitter or YouTube

Other (not listed above)

NOTES TO THE EPSYO (Type N/A if not applicable)

**If you have any questions, you can call us at (915) 525-8978 or (915) 227-2299. **Si tiene preguntas adicionales, por favor llame al (915) 525-8978 o al (915) 227-2299.

STUDENT'S EMERGENCY INFORMATION (SEASON 2025-2026)

EPSYO Student's Name(Required)

Full Name Full Last

Mother's Information(Required)

Full Name Emergency Number

Father's Information(Required)

Full Name Emergency Number

Doctor's Information(Required)

Full Doctor's Name Emergency Number

#1 Relative/Friend Information(Required)

Full Name Emergency Number

#2 Relative/Friend Information(Required)

Full Name Emergency Number

STUDENT'S INSURANCE & HEALTH INFORMATION (SEASON 2025-2026)

Name of Insurance/Group #1(Required)

Name of Insurance/Group #2 (Optional if any)

Please list student's Medical Condition (if any)(Required)

Allergies

Heart Problem

Diabetes

Convulsions

Astma

Other

Not Applicable (No Medical Condition to be Listed)

Explain other Medical Conditions (If any)(Required)

Please list above any medical problems your child may have and you feel the EPSYOs should be aware of.

Student's Daily Medication(s) if any. Type N/A if not applicable(Required)

Please provide the name of any daily medications your child is taking.

Student's Prescribing Physician Information

First Last

Prescribing Physician Address

Physician's Prescribing Physician Phone Number

MEDICAL AGREEMENT (SEASON 2025-2026)

I do hereby authorize the staff of the El Paso Symphony Youth Orchestras (EPSYO) to permit its designated representatives to give consent to a physician and/or hospital for immediate and/or emergency medical and/or surgical treatment when necessary to our son/daughter for sustained injuries or sickness requiring emergency treatment during EPSYO events provided such events have an authorized representative of the EPSYO present. It is understood that the EPSYO or its representatives do not assume any financial responsibilities for any expenses that might be incurred for said emergency treatment, and the EPSYO will notify us as soon as possible following the emergency, but in no way is treatment to be delayed until we have been notified. I understand that EPSYO authorities and staff may inform other school personnel of my child’s medical condition(s) and/or disability when necessary for my child’s well-being.

By typing my name below, I am electronically signing this medical form, I am also responsible to provide to the EPSYO via email, medical updates or changes for my child in this medical form throughout the 2025-2026 EPSYO season for better emergency practice purposes.(Required)

Mother/Legal Guardian Signature Signing Date

Father/Legal Guardian Signature Signing Date

EPSYO HANDBOOK AGREEMENT (SEASON 2025-2026)

I have read and understood the content of the Membership Handbook and my responsibilities as an EPSYO member. I agree to abide by all the rules of the EPSYO and understand that failure to follow the rules laid out in the handbook may result in my dismissal without refund of fees. I understand that I am responsible to participate in the Vertical Raise fundraiser and to make a raffle tuition payment. (Raffle total is equivalent to $100 and is divided into two different sales of $50 each. The raffle is part of your child’s tuition and is non-negotiable.) **not applicable for summer camp** I understand that EPSYO activities may be recorded (audio and/or video) and photographed for use in both EPSYO and El Paso Symphony Orchestra (EPSO) publications, advertising, promotions, and website. I hereby agree to allow the EPSYO to use my photographic or video likeness in any publicity material, either printed or broadcast. All materials will remain the sole property of the EPSYO.

Mother/Guardian E-Signature(Required)

First Last

Date(Required)

Father/Guardian E-Signature(Required)

First Last

Date(Required)

Student E-Signature(Required)

Date(Required)