California Association of Professional Music Teachers SDSC- Adult Student Consent Waiver

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This is the Media Waiver and Consent & Release Agreement for participants 18 years and older.
By checking each box, you acknowledge that you have read and agree to that Term and Condition.

Email *

Media Waiver *

I hereby grant my consent to CAPMT to photograph, electronically record, transfer, or film for distribution in all media at any time, all public performances and appearances in or associated with a CAPMT Audition or Competition, including Piano Auditions, Ensemble Auditions, Contemporary Music Festival, Honors Auditions, and/or Concerto Competition, including all programs and events of San Diego South Chapter (SDSC), (collectively “CAPMT Event”), in which I participate or perform, without any compensation or remuneration. I also grant to CAPMT the right to use any such recorded performances, interviews, quotations or photographs; and the right to use my name, voice, image, and likeness in connection with a CAPMT Event, including but not limited to: publication in books, magazines, pamphlets, advertising, and newspapers; and on television, radio, internet, and social media channels, without any compensation or remuneration.

I would like to opt out of the media waiver.

Required

Consent & Release Agreement *

I hereby unconditionally release and discharge CAPMT, CAPMT agencies, departments, directors, officers, employees, volunteers, agents, CAPMT host or collaborating partners, and all other persons and entities involved with this CAPMT Event from any and all claims, demands, liabilities, damages, costs, and all other expenses that may arise in connection with my participation in a CAPMT Event.

I understand that the CAPMT Event has a physical element to it. I agree and understand that by signing this Waiver, the Minor is physically fit enough to participate as a volunteer or participant in the CAPMT Event. I hereby certify that the Minor is in good physical condition and that the Minor is able to participate in the CAPMT event without harm to the Minor or others. I agree to voluntarily assume all risks, known or unknown, of injuries, however caused to the Minor, even if caused in whole or in part by the action, inaction or negligence of the CAPMT host or collaborating partners, sponsor, individual and groups involved in the CAPMT event, and to hold the CAPMT host or collaborating partners, sponsor, individual and groups involved in the CAPMT event free and harmless from any liability or damages for any injuries that the Minor may sustain.

Required

I authorize myself to fully participate in a CAPMT Event. I understand that I, will provide necessary information in order to participate in a CAPMT Event. I consent to this practice. I understand that I may withdraw my permission granted herein, as set forth in CAPMT Privacy Policy. I also understand that it is important to provide accurate information in this consent form in case CAPMT needs to contact me for any reason. *

I consent

Required

CAPMT San Diego South Chapter

Specific Student Information

Teacher Name *

Applicant (Adult Student) Name *

Date *

YYYY

A copy of your responses will be emailed to the address you provided.

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