Harpool Middle School
Choral Department Handbook 2015-2016
9601 Stacee Lane Argyle, TX 76226
Ashley Delaney, Director of Choral Activities Bradley Kerley, Director of Choral Activities
Choir Office: (940) 369-1788 [email protected]; [email protected] http://www.dentonisd.org/harpoolms/choir
\ Page 1 HARPOOL MIDDLE SCHOOL LONGHORN CHOIRS: CURRICULAR
Concert Girls/Guys - Un-auditioned ensemble open to sixth grade students. This course series serves as the training choir for upper level choirs. Students enrolled in the course will develop their singing, listening, sight-reading, and music theory skills, as well as develop an understanding for music of different styles and cultures.
Chamber Choir - Auditioned choir open to eighth grade women only and specializes in the performance of treble choir music. An audition including sight-reading is required. Chamber Choir travels to UIL Concert & Sight-Reading Contest as a varsity treble choir each year and also competes in local and regional choral competitions. Membership requires attendance at extra-curricular activities, including concerts, rehearsals, and/or sectionals.
Men’s Chorale - Un-auditioned choir open to seventh and eighth grade men only and specializes in the performance of tenor-bass choir music. Previous enrollment in sixth and/or seventh grade choir is preferred, but not required. Men’s Chorale travels to UIL Concert & Sight-Reading Contest as a non-varsity tenor-bass choir and also competes in local and regional choral competitions. Membership requires attendance at extra-curricular activities, including concerts, rehearsals, and/or sectionals.
A Cappella Choir - Un-auditioned choir open to seventh grade and eighth grade women only and specializes in the performance of treble choir music. Previous enrollment in sixth and/or seventh grade choir is not required. A Cappella Choir travels to UIL Concert & Sight-Reading Contest and also competes in local and regional choral competitions. Membership requires attendance at extra- curricular activities, including concerts, rehearsals, and/or sectionals.
Women’s Chorale - Auditioned choir open to seventh grade women only and specializes is the performance of treble choir music. Previous enrollment in sixth grade choir is required. Women's Chorale travels to UIL Concert & Sight-Reading Contest and also competes in local and regional choral competitions. Membership requires attendance at extra-curricular activities, including concerts, rehearsals, and/or sectionals.
Varsity Men - Auditioned choir open to seventh and eighth grade men and specializes in the performance of tenor-bass choir music. Previous enrollment in sixth and/or seventh grade choir is required. Special attention is devoted to the understanding and challenges of the male changing voice. Varsity Men’s Chorus travels to UIL Concert & Sight-Reading Contest each year and also competes in local and regional choral competitions. Membership requires attendance at extra-curricular activities, including concerts, rehearsals, and/or sectionals.
HARPOOL MIDDLE SCHOOL LONGHORN CHOIRS: EXTRA-CURRICULAR
Harpool “One Voice” (HOV) - HOV is a premier choral ensemble at HMS and is open to seventh and eighth grade men and women by audition only. Students are expected to pass all classes and represent the Harpool Choirs in a positive and professional manner. Meets during advisory class. They are also expected to audition for the All-Region Choir. HOV travels throughout the community each year and also competes in local and regional choral competitions. Membership requires attendance at extra- curricular activities, including concerts, rehearsals, and/or sectionals.
Rebel Clefs – A premier choral ensemble at HMS and is open to seventh and eighth grade women by audition only. Students are expected to pass all classes and represent the Harpool Choirs in a positive and professional manner. Meets during advisory class. This group travels throughout the community each year and also competes in local and regional choral competitions. Membership requires attendance at extra-curricular activities, including concerts, rehearsals, and/or sectionals.
Acafellas – A premier choral ensemble at HMS and is open to seventh and eighth grade men by audition only. Students are expected to pass all classes and represent the Harpool Choirs in a positive and professional manner. Meets during advisory class. This group travels throughout the community each year and also competes in local and regional choral competitions. Membership requires attendance at extra-curricular activities, including concerts, rehearsals, and/or sectionals.
HMS Choral Handbook 2
CHOIR SUPPLIES In order for successful rehearsals to take place, all students must be prepared for class each and every day. Failure to bring required materials will result in a grade reduction. All students should acquire the following materials for the school year:
♪ 12 Pack of #2 Yellow Pencils (sharpened preferred - to be used by all students) ♪ 1 Pack of Highlighters ♪ ½ Inch Black Binder ♪ 1 Box of Kleenex
Other materials (worksheets, homework assignments, etc.) will also need to be brought to class on their due dates or when instructed by the director(s) FEES AND EXPENSES Most costs of participating in choir are covered by the HMS Choral Department’s budget; however, participation in choir does require some financial commitment.
To help offset these costs, a $55 choir fee is due by September 12. This fee includes a t-shirt and choral octavos. The fee also helps to subsidize costs for transportation, trips, festivals, and other social events.
Other costs associated with the HMS Choirs are optional and are dependent on the student’s participation in OPTIONAL events.
FUNDRAISING The HMS Choral Department will be participating in fundraising activities throughout the year. There are many costs that go into operating a choral program, and the school district gives us only a portion of that money; therefore we must fundraise the rest. Each student is expected to sell $100 worth of merchandise to help us pay for our program’s needs. If a student does not want to participate in the fundraiser, they may opt-out by writing a check to the choral department for $50 – the amount of profit we would receive from participating in the fundraiser. Students choosing not to participate in the fundraiser or the opt-out program will not be allowed to go on spring trips.
Note: Finances should never affect a student’s participation, progress, or potential in choir. In the event that finances become a concern, please contact the director(s)—arrangements can often be made in these situations.
TRIPS Seventh & Eighth Grade (Chamber Choir, Varsity Men’s Chorus, Men’s Chorale, Women’s Chorale, A Cappella, & Pop Choirs) The seventh and eighth grade spring trip will be to San Antonio. The cost per student and chaperone is still being determined as of today. The cost of the trip is $225. This cost includes the bus fee of $75, all competition fees, two nights hotel accommodations, entrance into Schlitterbahn, Fiesta Texas, some meals, and a trip t-shirt.
All Seventh and Eighth Grade Trip Money is Due Friday, March 7! Students and parents should understand that all choir students have the opportunity to raise money to cover the expenses of their spring trip and a trip payment plan can be picked up from a director at the start of the year. However, after March 7, trip money is non-refundable regardless of the reason.
Sixth Grade (Concert Boys & Concert Girls Choirs) The sixth grade spring trip will be to Hurricane Harbor in Arlington. We will be missing a school day, competing in a choral competition and returning to Hurricane Harbor on Saturday to play at the park. The cost of the trip is $25, and includes the ticket to Hurricane Harbor.
All Students Must Be Passing Classes on the Given Date to Participate in the Spring Trips! See “Eligibility” for more information. Important Note: If a student fails a class or is removed because of behavior problems after paying the trip cost, no refunds will be issued because monies will have been sent to the travel company to pay for trip costs.
HMS Choral Handbook 3
CLASSROOM PROCEDURES 1. Be an ambassador for Harpool Middle School. Show kindness and respect to others at all times. 2. For your safety stay on the risers unless you have permission to leave them. 3. Respect the personal space and safety of others. 4. Participate in all class activities, monitor your tardiness, and care for your supplies. 5. Make the most of every musical minute!
STUDENT EXPECTATIONS As music educators, we believe that occasionally students need time to step away from the stimulation of the choral environment to reflect on choir classroom procedures, calm their behavior, or separate his or her self from the current activity if they are unable to perform without distressing or disturbing others. As opposed to punishment, this gives the student the ability to find acceptance as a valued member of the team who requires a moment to reestablish the connection between his or her actions and the needs of the classroom. The student will be asked to step away from the learning environment after they are given verbal notice from the director alerting them that they are hindering the procedures of the classroom and their action is needed to improve the learning environment. After a short period of time, the teacher will check on the student to see if he or she is ready to rejoin the class. Student learning and musical achievement is the ultimate goal.
♪ Step 1: The student has chosen to distress the classroom after a verbal notice from the director has been given and personal reflection is needed to improve the learning environment. The student will be asked to sit away from others, to ensure that he or she is able to stop the activity and quietly reflect. ♪ Step 2: The student chooses to continue distressing the classroom and a second reflection in the form of a written refocus activity is needed to identify the procedure infraction. The student will be asked to sit away from others to refocus to ensure that he or she is able to stop the activity and quietly reflect. ♪ Step 3: The student chooses to continue distressing the classroom and a third personal reflection is needed to improve the learning environment. Parent support is needed upon stepping out for a third time and a phone call will be made. The call will be made to discuss positive actions that the teacher can implement to improve student success in choir. ♪ Step 4: The student chooses to continue distressing the classroom and an office referral is needed to improve the learning environment. Administration and parent support is compulsory upon stepping out for a fourth time and contact will be made immediately following the incident to set up a parent/teacher conference. Administration will decide whether further action should be taken to improve the future of student success in class. Any action that warrants a direct violation of student safety or direct insubordination of authority will be considered an automatic Step 4.
STATE & NATIONAL MUSIC EDUCATION STANDARDS While at Harpool Middle School, choir members learn a wide range of quality choral repertoire ranging from classical and jazz to spirituals and multicultural music, spanning from the Medieval to Contemporary periods. HMS choral rehearsals are centered on the six standards listed in the Texas Essential Knowledge and Skills (TEKS): 1. Perception – the student describes and analyzes musical sound and demonstrates musical artistry. 2. Creative expression/performance – the student sings, individually and in groups, performing a varied repertoire of music. 3. Creative expression/performance – the student reads and writes music notation. 4. Creative expression/performance – the student creates and arranges music within specified guidelines. 5. Historical/cultural heritage – the student relates music to history, to society, and culture. 6. Response/evaluation – the student responds to and evaluates music and musical performance. In addition to learning strong choral repertoire, HMS choral rehearsals also address the nine national standards of music education, as determined by the Music Educators National Conference (MENC): 1. Singing, alone and with others, a varied repertoire of music. 2. Performing on instruments, alone and with others, a varied repertoire of music. 3. Improvising melodies, variations, and accompaniments. 4. Composing and arranging music within specified guidelines. 5. Reading and notating music. 6. Listening to, analyzing, and notating music. 7. Evaluating music and music performances. 8. Understanding relationships between music, the other arts, and disciplines outside the arts. 9. Understanding music in relation to history and culture
HMS Choral Handbook 4
GRADING POLICIES Daily Grade/Assignments/Rehearsal Accountability/Concert Attendance & Etiquette Assignments such as sight-reading tests, memory checks, music analyses, and web-based assignments will be given at the discretion of the director(s). Doing so allows assessment of the student at an individual level, rather than as a group. The student’s daily grade consists of work done during the choral rehearsal.
Attendance is required for all concerts, sectionals, and outside rehearsals, as they are a form of assessment in choir. Performance dates are listed on the calendar of events, and other extra-curricular activity dates will be given to students with adequate notice. An excused absence will be awarded only on a case-by-case basis. Concert grades are double-weighted. One grade is given for performance and the other is given for concert etiquette. Concert grades are figured with the following guidelines: If a student is ineligible for a concert, or has been granted an excused absence, they will be given an alternative assignment to replace the zero in the grade book. UIL Competition is a required performance for the year. The Harpool Choral Department will follow grading guidelines put forth by Denton Independent School District.
ATTENDANCE POLICIES Rehearsals - Unlike other academic classes, it is impossible to make up activities that occur during a choral rehearsal, thus attendance is imperative at all rehearsals, concerts, and extra-curricular activities. Excessive unexcused absences will have a negative effect on the student’s grade.
Concerts - Attendance at any choral concert is required. Missing a concert will lower the student’s grade drastically. Absences will only be excused in special situations, such as a medical/family emergency, religious holiday, or death in the family. Written documentation should be provided to the director(s) as soon as a problem arises and must occur prior to the event to be given a concert makeup opportunity. Note: Non-school-sponsored events do not constitute an excused absence for any required choral event and will not be allowed a makeup.
Extra-Curricular Activities - Students will be given sufficient notice of any activities outside of the school day, including rehearsals, sectionals, and concerts. These activities are essential to the development of the choral program. As with concerts, an unexcused absence at an extra-curricular activity will lower the student’s grade. The director(s) will make every effort to limit the time spent outside of the school day. Any conflicts, including appointments, athletics, other student organizations, etc. should be brought to the director(s) as soon as possible.
ELIGIBILITY According to University Interscholastic League (UIL) rules and House Bill 72 (No Pass/No Play), a student must stay academically eligible in order to participate in an extra-curricular activity.
Students are required to participate in all class rehearsals and performances where admission is not charged, regardless of eligibility.
Students who are ineligible will not be allowed to participate in the following:
♪ Any HMS choral concert where admission is charged/All-Region Choir Auditions & Concerts/Solo & Ensemble Contest/ UIL Concert & Sight-Reading Contest/Choir Field Trips (including Spring Trips)/Any event where we leave campus by means of school transportation
In order to receive a grade for these situations when ineligible, appropriate written assignments will be given. A student who is ineligible after the six-week grading period cannot become eligible until the three-week mark of the following grading period, granted that he/she is passing the class failed on the report card. Students cannot lose eligibility at the three-week mark if they passed their classes on the previous six weeks report card.
HMS Choral Handbook 5
UNIFORMS At the beginning of the year, measurements will be taken to help fit you with a uniform. The uniforms will be issued to you at the beginning of the school year. You are responsible for them over the course of the year.
Formal Uniforms – 7th & 8th Grade These will be worn in formal concerts, including UIL, festivals, and HMS fall, winter, and spring choir concerts.
7th & 8th Grade Women: ♪ Choir dress ♪ (Student provided) - Black dress shoes (closed toe, up to 2” heels acceptable) & Black hose or knee-high stockings
7th & 8th Grade Men: ♪ White tuxedo shirt/Choir vest/Black pants/Bow tie ♪ (Student provided) Plain white t-shirt to be worn underneath/Black socks/Black dress shoes
Casual Uniforms – All Grades (Men and Women) These will be worn in casual situations where we want to be uniform, but not formal. ♪ HMS Choir t-shirt - Tucked in ♪ (Student provided) Blue jeans (must cover the entire leg)/Tennis shoes
Jewelry & Hair: ♪ Women may only wear studs in their ears. No necklaces, hair bows, watches, or bracelets are allowed. Men, no earrings are allowed. Hair must be away from the eyes.
UNIFORM CARE PROCEDURES – MEN Tuxedo Shirts ♪ Shirts should be washed after EVERY performance. No exceptions. If you have outgrown your shirt, please let a director know as soon as possible (not the day before a concert).
Tuxedo Pants ♪ Pants should be washed after EVERY performance. No exceptions. DO NOT dry the pants in the dryer. They MUST be hung up to dry. After washing your pants, you may notice that the crease is gone. Ask your parents to iron the pants for you on LOW heat if needed. ♪ If you have outgrown your pants, please let a director know as soon as possible (not the day before a concert). They should hang to your ankles. If the waist is too tight, try to adjust the pants with the silver tab on the side before contacting a director. ♪ If you have to hem your pants, take them to a dry cleaner that does alterations. **DO NOT cut the pants, or you will have to replace them. Typical hemming costs are $5-$8.**
Vest & Bow Ties ♪ Vests should only have to be cleaned once – after the final performance. Wash the vest, but DO NOT dry it in the dryer. Instead, hang it up to dry. ♪ Bow ties do not need to be washed. Please return them in good condition.
ALL ITEMS MUST BE RETURNED DRY-CLEANED & IN GOOD CONDITION Replacement costs are: If a student fails to turn in a uniform, they will be charged for each item Tuxedo Pants $40.00 missing. You will be assessed a fine and will not advance to the next grade Tuxedo Vest $20.00 until the fine has been paid. **Uniforms must be turned into the choir Bow Tie $7.50 department at the end of the year in a DRY CLEANING bag with tagged Tuxedo Shirt $20.00 receipts and the student’s name must be clearly marked on the bag.** Cleaning Fee: $5.00
HMS Choral Handbook 6
UNIFORM CARE PROCEDURES – WOMEN Dresses ♪ Dresses should be washed after EVERY performance. No exceptions. These dresses need to last for a long time. Wash the dress, but DO NOT dry it in the dryer. Instead, hang it up to dry. ♪ If you have outgrown your dress, please let a director know as soon as possible (not the day before a concert). ♪ If you have to hem your dress, take them to a dry cleaner that does alterations. Your dress has been marked where the dress should be hemmed. **DO NOT cut both layers of the dress, or you will have to replace it. You MAY have the dry cleaner cut the inside layer of the dress where the hem needs to take place so that only one layer is hemmed. If you have a question, please ASK! Typical hemming costs are $10-$15.**
ALL ITEMS MUST BE RETURNED DRY-CLEANED & IN GOOD CONDITION Replacement costs are: If a student fails to turn in a uniform, they will be charged for each item Choir Dress $70.00 missing. You will be assessed a fine and will not advance to the next grade until the fine has been paid. **Uniforms must be turned into the choir department at the end of the year in a DRY CLEANING bag with tagged receipts and the student’s name must be clearly marked on the bag.**
PARENT VOLUNTEERS (“FRIENDS OF HARPOOL CHOIR”) Parent volunteers are always needed in the HMS Choral Department, especially in the areas listed below! If you are interested in volunteering your time and becoming a member of Friends of Harpool Choir, our parent organization, please contact a director or through e-mail. Thank you in advance!
CHARMS OFFICE MUSIC ORGANIZATION SOFTWARE CHARMS Office is a music organization software program used by all music groups in Denton ISD. It allows the director, student, and parents to track student information, schedules, fundraising, forms turned in, fees paid, choir calendar, and much more. It is a way for me to post documents to you to download if you use them. It also enables me to send mass e-mails to each choir student/parent to keep you better informed. It is very important that your information (particularly student & parent e-mail addresses) is correct. Please see CHARMS Office Form for additional information.
VOICE LESSON PROGRAM
Supplementary music lessons are offered as a supplement to classroom instruction. These lessons are designed to utilize the characteristic literature of the voice, rather than to rehearse the music a student will be performing in his/her school organization. Participation in these supplemental lessons is optional. Students who elect not to participate in the Supplemental Voice Lesson Program will not be penalized in their classroom activities. All students will have access to supplemental music lessons. Students must be fully prepared for each lesson, follow guidelines for absences, provide documentation of any required practice time, supply method books and other materials, and meet the criteria for student participation.
Parents must turn in monthly payments to the program on time, encourage the student to practice daily and sign weekly time cards, and provide reassurance and encouragement to the student regarding recitals, auditions, etc. Lessons will be taught during the school day and at the school in which the student attends.
A payment of $18.00 per lesson should be pledged and a check for that amount made out to the lesson teacher. He/she will collect payment from student for services rendered each month and will track lesson attendance, payment, etc. Please see Voice Lessons Interest Form for additional information.
Disclaimer: All information in this handbook was accurate at the time of printing of this document. All dates and times should be considered tentative until the director gives the final word.
HMS Choral Handbook 7
2015 – 2016 HARPOOL MIDDLE SCHOOL LONGHORN CHOIR CALENDAR AUGUST 2015 28 Handbook, Acknowledgement, and Forms Due (Required)
SEPTEMBER 2015 8-10 Legally Blonde Jr. Auditions, 3:30-6:00pm (Optional) 10 Choir Fundraising Kickoff! Choir Room (During Class) 11 Choir Fees Due - Final Date (Required) 28 Choir Fundraiser Due - Final Date (Required)
OCTOBER 2015 10 All-Region Choir Auditions @ Northwest High School, Justin, TX 8:00am-6:00pm (Optional) 13 6th Grade Fall Concert: HMS Cafetorium - After School Rehearsal 3:30-4:30pm, Concert 7:00 pm (Required 6th Grade Only) 16 7th & 8th Grade Fall Concert: HMS Cafetorium - After School Rehearsal 3:30-4:30pm, Concert 7:00 pm (Required 7th & 8th Only)
NOVEMBER 2015 14 7th & 8th Grade, All-Region Choir Clinic/Concert @ Chisholm Trail HS, 4:00 pm (Optional) 19-21 Legally Blonde, Jr. Cafetorium, Performance 7:00pm (Optional)
DECEMBER 2015 7 Winter Voice Recital: HMS Cafetorium, 6:30 pm (Required for Private Voice Students Only) 11 Choir Cares: Home for the Holidays, Choir Room (During Class) 12 Choir Cares Caroling: Good Samaritan Nursing Home, 10:00-11:00am (Optional) 15 6th Grade Winter Concert: Location TBD – 5:45pm (Call time), Concert 6:00 pm (Required 6th Grade Only) 15 7th & 8th Grade Winter Concert Location TBD – 6:45pm (Call time), Concert 7:00 pm (Required 7th & 8th Grade Only)
JANUARY 2016 22 Choir Games: Social Event 6:00-9:30 pm (Optional) 31 7th and 8th Grade Trip Deposits Due $50 (Required for all students attending the trip)
FEBRUARY 2016 10-13 Ms. Delaney and Mr. Kerley at TMEA Convention – San Antonio 23 Pre-UIL Concert: Guyer High School, 4:30-8:30pm (Required 7th & 8th Grade Only)
MARCH 2016 4 7th and 8th Grade Trip Final Payments Due $175 (Required for all students attending the trip) 10 UIL Sight-Reading and Contest: Krum High School, 8:00am-4:30pm (Required 7th & 8th Grade Only) 24 6th Grade Spring Concert: HMS Cafetorium, After School Rehearsal 3:30-4:30pm, Concert 7:00 pm (Required 6th Grade Only)
APRIL 2016 9 Harpool Solo & Ensemble Contest @ Harpool MS (Required of Private Voice Students Only) 14 Spring Show Solo Auditions and 2016-17 Pop Choir Auditions – Choir Room (Optional)
MAY 2015 12 Spring Voice Recital: HMS Cafetorium, 6:30pm (Required Private Voice Students Only) 19 6th Grade Spring Concert: HMS Cafetorium, After School Rehearsal 3:30-4:30pm, Concert 7:00 pm (Required 6th Grade Only) 20-22 7th and 8th Grade San Antonio Trip (Optional) 24 7th & 8th Grade Spring Show: HMS Cafetorium After School Rehearsal 3:30-4:30pm, Concert 7:00 pm (Required 7th & 8th Grade Only)
HMS Choral Handbook 8
NOT REQUIRED FOR 7TH & 8TH GRADE STUDENTS PLEASE RETURN TO THE CHOIR DEPARTMENT SAN ANTONIO TRIP CONTRACT PERMISSION FOR SCHOOL-SPONSORED TRIP, MAY 20-22, 2015 By signing this contract, I am making a commitment to the San Antonio trip that will take place from Friday, May 20 to Sunday, May 22. This trip is optional. I understand that to reserve my spot, a $50 deposit is due by the end of January. I will be responsible to pay the remaining $175 by Friday, March 4. The total cost of the trip is $225. I also understand that this fee is non- refundable. After the fee is paid on March 4, it cannot be returned if the student is unable to attend regardless of the reason. Final payments for charter buses, hotel, contest, Fiesta Texas, Schlitterbahn, t-shirts, etc. are due in March and we do not receive a refund for students who become ineligible due to grades, behavior problems or for any other reason. Grades & Behavior: Students will not be allowed to go on the trip if they have failing grades (less than 70) on the fourth and fifth six weeks report cards. Also, if a student is assigned to ISS in the spring semester, he/she will not be allowed to go on the trip and will forfeit all monies paid. Behavior problems in choir (or any other class) including excessive detentions will keep a student from going on the trip. Those who go to San Antonio EARN it by passing all of their classes and by being a model citizen in school. Please sign below if you will make the commitment to go on this choir trip. This affirms that you understand all trip policies and that you will pay the required fees by March 4th. Parents: We will need several parent chaperones. Chaperones are accepted on a first come, first serve basis. Please begin making your payments as soon as you can. The cost is $225 per chaperone. We hope you can join us as we make our annual trip to San Antonio!
______Students Name has my permission to go with the Harpool Middle School Choir on a field trip to San Antonio.
______Parent/Guardian Signature Date
Please mark on this sheet if you are interested, as we must have chaperone help in order to attend this trip.
I will be attending as Chaperone: YES NO If YES please indicate Chaperone Name: ______
HMS Choral Handbook 9
NOT REQUIRED FOR 7TH & 8TH GRADE STUDENTS PLEASE RETURN TO THE CHOIR DEPARTMENT SAN ANTONIO MEDICAL RELEASE FORM RELEASE FORM FOR SCHOOL-SPONSORED TRIP, MAY 20-22 2016 TRAVEL PERMISSION - By signing below, you grant permission for your child to travel with Harpool Middle School Choir to San Antonio, and understand that the school is free from liability and responsibility in case of accident on the trip. It is also understood that the pupil is directly responsible to those teachers/chaperones sponsoring the trip from the time of leaving until returning, the same as if in regular school attendance. Pupils must go and return by the same transportation unless by mutual agreement of both sponsors and parents through written approval. It is further understood that if the above agreement is not satisfactory to you, you will refrain from signing this permit. Your student cannot go on the trip unless this is signed. MEDICAL TREATMENT PERMISSION – I, the undersigned, also do hereby authorize officials and sponsors of Harpool Middle School to contact directly the person(s) named on this document, and do authorize the named physician(s) to render such treatment as may be deemed necessary in an emergency, for the health of said child. In the event physicians, other persons named on this form, or parents cannot be contacted, the school officials are hereby authorized to take whatever action is deemed necessary in their judgment, for the health of aforesaid child. I will not hold the school financially responsible for emergency care and/or transportation of said child. In the event of any emergency during the choir trip to San Antonio, TX on 5/20/16 - 5/22/16, I the undersigned also grant authority to be exercised at the discretion of A. Delaney or B. Kerley to dispense OTC medication (Tylenol, Pepto-Bismol, etc.)
Full name of Child –
Home Address - Area Code and Phone#
City, State, Zip Code -
Date of Birth
Name and Phone # of nearest relative –
Known Medical Problems/Drug Allergies/Current Medications –
Child’s Private Physician and Phone #
Insurance Information (company and contact info.)
Party Responsible for Payment –
Signature of Parent/ Guardian - Date –
HMS Choral Handbook 10