US Instrument Use Permit

All Upper School students take orchestra class daily and need an instrument to use during in-person class and to practice at home. Before a student is allowed to take an instrument home, a parent/guardian must submit an Instrument Use Permit Form (Permiso de uso del instrumento). All orchestra students need to complete the form even if they bring their own instrument or play bass.

No instruments can leave the building without a signed permit form on file. 

Due date: Tuesday, August 10

On the form, please complete the following fields only.

Student Name
Instrument (if 6th grade, leave blank)
Sign, date, print name and parent email

Signed forms can be submitted in the following ways:

  • Scan and email directly to Miss Pokorny
  • Drop off hard copy at Registration event (August 3)
  • Drop off hard copy at US Orientation (August 9)
  • Drop off hard copy on the first day of classes (August 10)


Questions? Please contact Miss Pokorny, Orchestra Administrator: 

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