Lilac City Community Band Registration Form Payor Name(required) Phone Number(s)(required) Email(required) Complete Mailing Address (Street #, City, ST, Zip)(required) If new, How did you hear about us? LCCB Member Name(required) Birthday Instrument(required) $35 per quarter for Fall, Winter & Spring, $10 for Summer Discounts: 2 or more family members are only $50 per quarter. -$5 Discount for registering for Year in advance (Fall, Winter, Spring) Please note: There is a $2 processing fee for credit card payments. Session Sign Up:(required) Fall Winter Spring Summer More than one family member Additional Family Member(s) (include name(s), birthday(s) + instrument(s), alternate contacts if applicable) Copy & paste into text field if easier Electronic Signature of Person Responsible for Payment (Type Name) (required) The HNMC office will email invoice with payment link within 1-2 business days. (Apple Pay) Charge my card on file Call me for credit card info I will mail in a check (make payable to HNMC or Holy Names Music Center) Other Submit Δ *Please make sure all (required) fields are completed before pressing ‘Submit’