Required: Review the Consent to Participate and complete the signature portion at the end. You will not be able to submit the form until this is completed. Consent to Participate & Waiver of Liability Consent to Participate / Conduct
I/We (Parent/Guardian of Student, and the "Student" requests to be a participant in the Music Education Program offered by the Helen L. Fox Gospel Music Center (HLFGMC). Parent/Guardian and Student understand that Student shall act responsibly and with self-control while participating in the Program. Student and Parent/Guardian acknowledge that Student is a person able to make reasonable decisions about his/her conduct and Student shall accept full responsibility and accountability for such conduct while participating in the Program. Student agrees to abide by the code of conduct, policies and procedures of the HLFGMC as well as the Douglass Community Association building code while participating in, going to and coming from the Program. Misconduct may be subject to discipline including suspension or removal from continued participation in the Program.
Student and Parent/Guardian agree to be subject to the policies of HLFGMC including policies related to attendance, tardiness, at home practice, and other policies as issued. Student and Parent/Guardian understand that each student enrolled into the Program is expected to attend each lesson/rehearsal/recital as scheduled. HLFGMC will make every attempt to advise of schedule changes as soon as possible. Student and Parent/Guardian agree to give advance notice of unavoidable absences. An excessive number of unexcused absences or absences with no advance notice will be grounds for removal from the Program.
Consent to Photograph/Video/Media Use
Student and Parent/Guardian grants permission to the HLFGMC to take and use the Student’s image, likeness, audio and video recordings for purposes of HLFGMC media purposes to include but is not limited to its website, social media pages, brochures and/or other marketing materials or submissions for community events, fundraisers, grant applications and the like. We waive any compensation as a result of this activity. I retain the right to withdraw this permission in writing to the HLFGMC however, I understand that any print, media, audio, visual or other materials previously published in reliance on this permission may not be able to be retrieved.
Waiver of Liability Claims/Hold Harmless
As a condition of Student’s participation in the Program, Student and Parent/Guardian agree to indemnify, hold harmless and waive all claims or suits for damages or injury arising from the Student participating in the Program and liability against the Helen L. Fox Gospel Music Center, its officers, agents, employees, contractors, and volunteers, personally, individually, jointly or severally liable for injury, accident, illness during or by reason of this Program participation. Parent/Guardian waive any and all rights to hold the HLFGMC for any and all claims.
Payment terms and conditions will be negotiated subject to the policies and procedures of the HLFGMC, which may be amended, from time to time with the giving of notice to Student and Parent/Guardian.
Signature & Acceptance
By typing your name and submitting this form you verify and agree that it will be legally binding and enforceable and the legal equivalent of your handwritten signature, pursuant to the Uniform Electronic Transmissions Act, PA 305 of 2000, MCL 450.831 et. seq.
Signature: Type your name:*
Required: I have read and agree to the contents of this notice. I certify that I am the Parent/Guardian of the Student or an authorized agent of the same.