Release of Liability for Student Participation in
School-Sponsored Trip(s)

Murphy Middle School
2018-2019 Activities
Grades 6,7,8

Email address *
Electronic Signature Authorization *
I agree that the electronic digitized signatures I apply on this document are representations of my signature and are legally valid and binding as if I had signed the document with ink on paper in accordance with the Uniform Electronic Transactions Act (UETA) and the Electronic Signatures in Global and National Commerce Act (E-SIGN) of 2000.
I understand and consent to the responsibilities outlined in the Distict's Student Code of Conduct. I also understand and agree that my child shall be held accountable for the behavior and consequences outlined in the Student Code of Conduct at school, and at school-sponsored or school-related activities. Students involved in extracurricular activity are held to a higher standard of conduct. PISD views participation in extracurricular activities as a privilege not a right. I understand that any student who violates the Student Code of Conduct shall be subject to disciplinary action. This includes any misconduct, regardless of time or location that would reflect negatively upon representing Plano ISD in the Murphy MS Orchestra Program.
Travel Release
I desire that I, my son/daughter will be allowed to participate in the activities and travel with the Murphy MS Orchestra to and from the activities listed on the Murphy MS 2018-2019 Orchestra Calendar.

I fully understand that transportation to and from the events attended by the group listed could create risk to my health or safety. I, the undersigned, assume full and complete responsibility for any injury or accident that may occur to me while traveling to or from the activities in transportation provided by the District. In consideration of Plano Independent School District allowing me to participate in the activities of the above-referenced group and other good and valuable consideration, the receipt of which is acknowledged, I hereby release and waive all claims that I may have against the Plano Independent School District, its Board of Trustees, employees, agents, and representatives resulting, in whole or part, from me traveling to and from the events attended by the group listed above while traveling in transportation provided by the District. The release and waiver will be binding on my heirs, legatees, administrators, and assigns.
Parent's Full Name *
Your answer
Student Last Name *
Your answer
Student First Name *
Your answer
Preferred Cell # for communication *
used in "Remind" communication
Your answer
Student's Instrument *
Student Shirt Size *
Shirts are ordered in ADULT sizes
Student's Orchestra Class *
Please confirm each of the following:
visit www.mmsorch.com to view the following items. *
Consent *
I consent to allow the Murphy Orchestra Department to use my child's name, picture, art, written work, voice, verbal statements, or portraits (video or still).
Private Lesson Reservation
•Individual study with a specialist on the student’s instrument is vital to ensure development and continuity of proper playing habits. Although private study is not required, we strongly recommend it as a means of achieving greater musical growth for all students. Private lessons are $20.00 per week for one ½ class lesson every week. Billing and payment for the lessons will be arranged with the individual lesson teacher. These lessons are usually taught during the student’s orchestra class or before/after school (if possible). Some lesson teachers also have time available at their home studio. If you are interested, please contact your director. •M.M.S.O. is fortunate to be able to offer our students a highly qualified faculty from whom private lessons are available. Each faculty member is interviewed, auditioned, and approved by P.I.S.D., and is an authority on his or her own instrument. Student’s responsibility to the lesson teacher: •Be fully prepared for each lesson. •Instructor’s guidelines as to practice must be followed. •Supply method books and other materials as required by the lesson teacher. •Students will be able to participate in activities related to their private lessons. It will be the responsibility of the student to notify his/her lesson instructor at least 24 hours in advance if a lesson is to be cancelled unless in the case of an emergency. A two week notification should be provided in the event lessons must be terminated. Please make an effort to plan for lessons to be a year long commitment. This is a courtesy which is also the responsibility of the private lesson instructor if a lesson must be cancelled. *
If possible, please schedule my child to take private lessons with:
Your answer
Parent Volunteer
Please make an effort to help with at least one of these events:
A copy of your responses will be emailed to the address you provided.
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