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2019 Centennial HS Marching Band Registration
Registration requires completion of:
--- 2019 Marching Band Intent Form
--- Payment of $200 non-refundable deposit
--- This Google Form
Email address *
Untitled Title
STUDENT Consent, Acknowledgement & Release from Liability
I know of the risks involved in participation in indoor and outdoor physical activities such as traveling to and from Centennial High School Band activities, personal involvement in such activities, including but not limited to practices, marching band camp, trips, competitions, fundraising events, running, swimming and other forms of physical activities and exertion, and the possible presence of insects, reptiles and other wildlife. I understand that serious injury, illness, and even death, are possible in such participation, and choose to accept such risks. I further state there is no medical condition that I have that would prevent me, or increase my risks, from participating in these activities. I voluntarily accept any and all responsibility for my own safety and welfare while participating in these activities, with full understanding of the risks involved. If I have specific conditions, such as heightened sensitivity to insect bites or other medical condition, I shall be responsible for bringing appropriate medication (the handling of which shall be pursuant to Fulton County School guidelines). Should I be 18 years of age or older, or should I be emancipated from my parent(s)/guardian(s), I release and hold harmless Centennial High School and its governing organizations, the Centennial High School Band Boosters, Inc., and those teachers, administrators and parents involved in sponsoring, supervising, chaperoning or otherwise assisting in such activities of any and all responsibility or liability to me or my personal representatives, estate, heirs, next of kin, and assigns for any injury or claim resulting from such participation, whether caused by negligence or otherwise, and agree to take no legal action against any of them because of any accident or mishap involving my participation in any of such activities. I further hereby authorize the use or disclosure of my individually identifiable health information should treatment for illness or injury become necessary. I agree to update my medical form if any medical condition occurs after the date below. I understand that this authorization regarding health information is voluntary and that I may revoke it at any time by submitting the revocation in writing to my school. Furthermore, I grant the released parties the right to photograph and/or videotape me and further to use my name, face, likeness, voice and appearance in connection with exhibitions, publicity, advertising, promotional and commercial materials without reservation or limitation. The released parties, however, are under no obligation to exercise said rights herein. I understand specifically that these activities will include:

- Participation in summer marching band camp and band competitions, including: physical activities, including but not limited to swimming at band camp or other elected trip (pool, lake and/or ocean), calisthenics, physical exercise, marching practices/performances, fundraisers or any other band activity.
- Travel to and from band camp, competitions, football games and other venues to participate in performances of the band.

I/WE HAVE READ THIS CAREFULLY, HAVE FULLY INFORMED MYSELF OF ITS CONTENTS, UNDERSTAND ITS INTENT, AND KNOW IT CONTAINS A RELEASE.

I assume responsibility for my physical condition and capability to perform these activities.

Student Name *
Your answer
Student ID Number *
Your answer
Student Instrument *
2019-2020 Grade *
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