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

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 address *
Media Waiver *
Required
Consent & Release Agreement *
Required
I authorize myself to fully participate in a 2019-2020 CAPMT Event. I understand that I, will provide necessary information in order to participate in a 2019-2020 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. *
Required
CAPMT San Diego South Chapter
Specific Student Information
Teacher Name *
Your answer
Applicant (Adult Student) Name *
Your answer
Date *
MM
/
DD
/
YYYY
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google.