Discovery Registration Form

2009 Philharmonic Discovery Concert Registration Form
The first ten schools to register will receive a free in-school visit prior to the performance!

School: District:
School Address City: Zip:
School Phone: School Fax:
Best time to call:

Teacher Name: Email:
Subject: Grade:
Time (10:00 or 11:30):

Attendence information:

Number of Students: @ $5.00 ea = $
Number of Chaperones FREE (1 per 10 students)
Number of additional chaperones @ $5.00 ea = $
TOTAL NUMBER ATTENDING = $

Transportation Information:

RESERVE YOUR BUSES EARLY! Each group is responsible for their own transportation.
We will be bringing buses
We will be using private transportation

Payment Options:

I will mail a check for Payment in Full within one week (make payable to Boulder Philharmonic Orchestra)

I will mail a $25 deposit within one week, and will confirm total attendance 30 days prior to performance. I understand that full payment must be received 30 days prior to the event.

I will pay in full using a credit card

Please charge my credit card for the $25 deposit and I will confirm attendance 30 days prior to performance. I understand that full payment must be received 30 days prior to the event.
Card Number: Exp. Date:
Name on Card:

I will mail a purchase order PO Number:

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Boulder Philharmonic Orchestra • 2995 Wilderness Place, Suite 100 • Boulder, CO 80301 •(303) 449-1343 info@boulder phil.org