Suzuki Early Childhood Education Class Free Trial Form

Parent Name *
Parent Name
Phone
Phone
Day/Time *
Please check all that apply
Parental Involvement *
In Suzuki Method parental involvement is critical. Therefore it is expected that parents attend class as often as possible with their child.
Media Waiver *
By initialing below, you acknowledge that you have read and agree to this Term and Condition. By initialing and signing below, you acknowledge you are the parent or legal guardian of the child participant indicated below (“Minor”). I hereby grant my consent, as the legal guardian of the Minor, to J and M Strings, LLC. AND Westside Music Conservatory (J&M Strings & WMC) to photograph, electronically record, transfer, or film the Minor for distribution in all media at any time, all public performances and appearances in or associated with J&M Strings & WMC without any compensation or remuneration. I also grant to J&M Strings & WMC the right to use any such recorded performances, interviews, quotations or photographs of the Minor; and the right to use the Minor’s name, voice, image, and likeness in connection with a J&M Strings & WMC 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.
Consent & Release Agreement *
By initialing below, you acknowledge that you have read and agree to this Term and Condition. By initialing and signing below, you acknowledge you are the parent or legal guardian of the child participant indicated below (“Minor”). I hereby unconditionally release and discharge J and M Strings, LLC. & Westside Music Conservatory (J&M Strings & WMC), J&M Strings & WMC agencies, departments, directors, officers, employees, volunteers, agents, J&M Strings & WMC host or collaborating partners, and all other persons and entities involved with J&M Strings & WMC from any and all claims, demands, liabilities, damages, costs, and all other expenses that may arise in connection with the Minor’s participation in J&M Strings & WMC. I understand that J&M Strings & WMC have 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 J&M Strings & WMC. I hereby certify that the Minor is in good physical condition and that the Minor is able to participate in J&M Strings & WMC 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 host or collaborating partners, sponsor, individual and groups involved in J&M Strings & WMC, and to hold J&M Strings & WMC host or collaborating partners, sponsor, individual and groups involved in J&M Strings & WMC free and harmless from any liability or damages for any injuries that the Minor may sustain.
Children's Online Privacy Protection Act (COPPA) *
By initialing below, you acknowledge that you have read and agree to this Term and Condition. By initialing and signing below, you acknowledge you are the parent or legal guardian of the child participant indicated below (“Minor(s)”). The Minor’s information is only used in connection with J and M Strings, LLC. & Westside Music Conservatory (J&M Strings & WMC) and is limited to the information requested below. It is our practice to only obtain information regarding children under the age of 13 from the child’s parent or guardian and not from the child directly. The Minor’s parent or legal guardian must consent for the collection, use or disclosure of the information requested below. J&M Strings & WMC will not share identifiable information of a child with any third party. J&M Strings & WMC will only send our promotional communications or newsletters to the parent or the legal guardian who provided the child’s information to us, and J&M Strings & WMC will not link, sell, trade, or otherwise transfer to outside parties’ personally identifiable information for any child under the age of 13. If the parent or guardian does not give their consent within a reasonable time, J&M Strings & WMC will delete the parent or guardian’s online contact information from our records. At any time you can review, change or delete your child's personal information, or revoke your parental consent by sending us an e-mail at jandmstrings@gmail.com. To protect your privacy and security, we may require you to speak with a representative or take additional steps or provide additional information to verify your identity before we provide any information, make corrections, or disable your child’s registration.