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Westmoreland Youth Symphony Orchestra Application

If you have any questions or concerns, please contact Ramona Coppage at

Student Information


Private Teacher (if applicable)

Parent/Guardian Information


Parent/Guardian #2

Additional Emergency Contact

To Whom It May Concern: I give my child permission and consent to participate in publicity and media activities on behalf of the Westmoreland Symphony Orchestra Academy of Music organization or activities related to WSO organization events, rehearsals, concerts, or publicity, including photographs, reproductions, audio/video recordings, recordings for television, radio or social media, webcasts, interviews, etc., and to exempt the WSO organization from obligation and/or remuneration for the use of such material for publicity, marketing or other purposes. Image/Video Use Permission I further hereby grant permission for photographs/image files and/or video files of my son/daughter to be posted on the WSO organization website, YouTube channel, and other electronic communication tools/social media, and to be posted on the websites of foundations or agencies or included in annual reports, publications or publicity related to WSO organization activities, reports, programs, materials or events.