AMADEUS PLAYERS 2012 REHEARSAL RETREAT
________________________________________________ has permission to attend the Salem Youth Symphony Association Amadeus Players rehearsal retreat on October 12-‐13 at the 4-‐H Center in West Salem. The retreat cost is included in the tuition fee. Signature______________________________________ Relationship_________________________ Date __________________________________________ Phone_________________________________ _____ I have returned the medical information and release form (Part of the SYSA registration form) Please indicate any special needs: foods, medications, etc. _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ Rooms will be assigned. Members I would like to room with: 1. 2. ______I am interested in being a chaperone for this trip. Chaperones are asked to pay the $40 fee. _____ I cannot chaperone but would like to stay for a meal. _____ Friday supper $8.50 _____ Saturday lunch $7.00 _____ My child needs a ride with another member. Salem Youth Symphony 503-485-2244 PO Box 1113
[email protected] Salem, OR 97308 www.salemyouthsymphony.org