Apply

Student Information

(Part 1 of 3)

Name*
Date of Birth*
 
Address*
 Street
 City, State, Zip
 
Home Phone
Student Cell Phone
Student Email
 

Parent Information

Email is the primary way we will contact you. Primary Parent/Guardian email should be the one you want notices sent to.

Primary parent/guardian

Name*
Cell Phone*
Email*
Place of Employment
 

Parent/guardian #2

Name
Cell Phone
Email
 

Musical Experience

Instrument(s)*
Years played*
'17-'18 Grade in School*
Where do you do your schooling?
Private Teacher name
Private Teacher email
Orchestra Teacher name
Orchestra Teacher email
List several solos, etudes, etc. that the student has studied:
List the scales the student has studied and how many octaves:
I am interested in performing the following movement from Vivaldi’s Four Seasons. I understand I will be contacted for an audition date/time.List season and movement:
 

Reminder: Your application must be accompanied by a recommendation from the student's private teacher or in the case of a student not having private lessons, their orchestra teacher. Recommendations should be email to Ms. Boland by the private or orchestra teacher to [email protected]. Please put "OPAYCO Recommendation – Student Name" as subject header.

Medical Information

(Part 2 of 3)

Additional Contact*
 in case of emergency
Phone*
 
Family Physician name*
Phone*
Health Insurance Carrier*
Policy Number*
List medical conditions/allergies
List medication that may be in the student's possession
 

Medical Release

You will receive a copy of this release via email.
I authorize OPACO staff, volunteers, or representatives to administer general first aid treatment for any minor injuries or illnesses experienced by the Minor. I acknowledge that if the Minor has a medical emergency, Oregon Pro Arte Chamber Orchestras (“OPACO”) staff and volunteers will attempt to call the people listed above. If they cannot be reached, I authorize OPACO staff, volunteers, or representatives to obtain medical treatment and procedures for the Minor as may be appropriate, including treatment by physicians and hospital and clinic personnel. I agree to assume financial responsibility for all expenses of such care.

I hereby release and hold harmless OPACO, and any persons or entities acting on behalf of or at the direction of OPACO, from any claim resulting or arising from any activities authorized by this Release. This agreement shall be binding upon me and my heirs, legal representatives, and assigns.

Typing your full name in this box signifies an electronic signature.
 
Confidentiality: The information on this form is used solely for the communication of medical information in the event of an emergency.

(Part 3 of 3)

Photo and Media Recording Release

You will receive a copy of this release via email.

As the Participant or the parent or legal guardian of the Participant, I hereby authorize OPACO to use, distribute, publish, exhibit, digitize, broadcast, display, or reproduce the Participant’s picture and likeness, or to refrain from so doing, in any manner or media whatsoever by persons or entities deemed appropriate by OPACO for educational, advertising, non-commercial, or commercial purposes. I agree that the photographs, video, or other media recordings are and shall continue to be the property of OPACO.

I acknowledge that since my and/or the Participant’s participation is completely voluntary, neither myself nor the Participant nor any third party connected with the Participant’s participation will receive financial compensation for the use of any photographs or media recordings.

I hereby release and hold harmless OPACO, and any persons or entities acting on behalf of or at the direction of OPACO, from all liability for any claims by myself and/or the Participant, or any third party in connection with the Participant’s participation, including any claims and demands ensuing from or in connection with the use of the photographs or other media, including any and all claims for libel and invasion of privacy.

I hereby affirm that I have read the above authorization, release, and agreement, prior to its execution, and I fully understand the contents thereof. This agreement shall be binding upon me and my heirs, legal representatives, and assigns.

Typing your full name in this box signifies an electronic signature.

 

Press "Submit" to complete your application. You will be automatically taken to our secure payment page to pay the $25 application fee. Alternatively, you can mail a check to:
Oregon Pro Arte Chamber Orchestra
PO Box 889
Wilsonville, OR 97070-0889
 Make check out to "OPACO", and put the name(s) of the student and "Application Fee" in the memo line.
Your application will be processed once the payment is received.
Please include the name of your student in the "Special Instructions" field (near the top of the page) to speed up the processing of your application.

You are being directed to our secure payment site to pay the audition fee. Please click here it the page does not refresh in 5 seconds.
Failed to submit the application. Please contact [email protected] to resolve the issue.
Failed to submit the application. Please contact [email protected] to resolve the issue.