Register For Pride of EA Booster Club

Marching Band 2026-2027

East Ascension High School Band

Parent Consent Form

Please fill out one per student. If you want to add a second parent, please email us at prideofeaband@gmail.com with Name, number and email address and we will get them added!

ATHLETIC PROGRAMS, AWARD PUBLICITY, HONOR ROLL LIST, ONLINE RESOURCES, TOPS COLLEGE SCHOLARSHIPS, NCAA, GRANTS, AID PROGRAMS, COLLEGE/UNIVERSITY ADMISSIONS, AND OTHER USES OF STUDENT INFORMATION

Some of your child’s information may be shared with the Louisiana Office of Student Financial Assistance(LOSFA), Louisiana High School Athletic Associations(LHSAA), various clubs and organizations that your child will join (BETA, FDA, FHA, etc.), local news media (athletics, and theatrical performances, graduation and award ceremonies, etc.), online resources and educational tools (digital library resources, homework help etc.), and postsecondary education institution(s) to which your child applies, school photography providers, and some other as detailed at https://iis apsb.org/privacy.

To allow your child to appear in event programs, be recognized for awards and achievements, take pictures for ID badges, take advantage of online resources, and to ensure eligibility for TOPS, you must sign to provide your consent.

If any parent/guardian does not agree to any specific use as described here for the student please express any objections, in writing, in a separate letter to the principal.

APSB will follow all local, state and federal data security rules and only share the data that is required for the purpose stated.

By signing below, I CONSENT to my child’s school collecting my child’s personal information and disclosing the personal information collected to:

LOSFA and postsecondary education institution(s) (Cumulative records required)
University Transcript Requests for Scholarship and Admissions
LHSAA, NCAA and sports programs
Programs for Graduations, Performances and Award Programs
Clubs and Organizations
Online Resources and Educational Tools

I understand and acknowledge that the consent provided herein shall be valid for my child’s cumulative transcript records as of the date of signature and shall remain valid and in effect until revoked in writing by parent or a student over the age of 18.

PLEASE USE STUDENT'S SCHOOL EMAIL FOR REGISTRATION

Student

First Name

Last Name

Phone Number

Address

State

City

Zip

Photo Authorization

Yes

Date of Birth

Graduation Year

Gender

Character limit (50) reached

Instrument for Marching Season

Character limit (50) reached

Relationship to Student

Character limit (50) reached

Insurance Company

Character limit (50) reached

Policy Number

Character limit (50) reached

Primary Care Doctor

Character limit (50) reached

Doctor's Phone Number

Have a medical problem or injury since his/her last evaluation?

Yes

Ever not been allowed to participate in activities for a medical reson?

Yes

Ever been hospitalized?

Yes

Presently take any medications?

Yes

Have allergies to medicine or insect bites?

Yes

Ever passed out during or after exercise?

Yes

Ever been dizzy and passed out during or after exercise?

Yes

Have had chest pain during or after exercising?

Yes

Tire more easily than their friends during exercise?

Yes

Ever been told they have a heart murmur?

Yes

Have racing of the hear or skipped hearbeats?

Yes

Has a family member that died of heart problems or sudden death before 50?

Yes

Have any skin problems?

Yes

Has had any head or neck injuries?

Yes

Ever had heat cramps?

Yes

Ever been dizzy or passed out because of the heat?

Yes

Has trouble breathing or coughing during or after strenuous activities?

Yes

Uses any special equipment? (pads, braces, neck rolls, eye guard, kidney belt, etc.)

Yes

Has any problems with vision?

Yes

Wears eyeglasses or contacts?

Yes

Ever sprained/strained, dislocated, fractured or repeated swelling of any bones or joints?

Yes

If you checked yes for any of the above, please explain.

Character limit (50) reached

Please list any current medications and dosages

Character limit (50) reached

Approximate date of last tetanus shot

Approximate date of measles immunization

Parent/Guardian Acknowledgement

The information is current and correct to the best of my knowledge.

I give my permission for my child to be examined for school-related activities.

If, in the judgment of a school representative, the named student needs care or treatment as a result of an injury or sickness, I do hereby request, consent and authorized for such care as deemed necessary.

I recognize the evaluation to be done on my child is a standard pre-participation screening examination and that no in depth testing, x-rays, lab work or cardiac testing will be performed.

I understand that if the medical status of my child changes in any significant manner after his/her physical examination, I will notify his/her principal of the change immediately.

I give my permission for my child to travel with the East Ascension high School Band as necessary during the current school year. I understand that all school and band rules are in effect and that any infraction of these rules will be dealt with accordingly.

Parent/Guardian Typed Signature

Character limit (50) reached

Today's Date

Parent/Guardian

First Name

Last Name

Phone Number

Address

State

City

Zip

Child's Graduation Year

Character limit (50) reached

Volunteer Interest

Concessions

Trailer Puller

Social Media

Band Camp Team

Online Merch Store

Special Events Team

Props Building Team

Register For Pride of EA Booster Club

Marching Band 2026-2027

East Ascension High School Band

Parent Consent Form

Please fill out one per student. If you want to add a second parent, please email us at prideofeaband@gmail.com with Name, number and email address and we will get them added!

**PLEASE USE STUDENT'S SCHOOL EMAIL FOR REGISTRATION**

Student

Parent/Guardian

Preview not Available

PLEASE USE STUDENT'S SCHOOL EMAIL FOR REGISTRATION