Timberline Music Permission Slip 2016-2017
Please return this form by September 12th.
Students Name: ______________________
Enclosed is 3.00 to purchase a recorder for my student. (3rd, 4th, and 5th
Enclosed is 10.00 for my student to participate in Choir ( 4th and 5th
To sign up for Orchestra or Band please go to: http://cceim.org/
Please return signed forms and money to Ms. Benton in the music room.
Student Signature: ________________________
Parent/Guardian Printed Name:___________________
Emergency Phone Number:______________________