NVMTA Photo and Media Release Form
I certify that I am the parent or the legal guardian of the child listed on this form and grant permission to the Northern Virginia Music Teachers Association (NVMTA) and the organization’s representatives permission to use photographs and/or videos including any live stream events put on or sponsored by NVMTA for this event.

The PARENT agrees to indemnify, release and hold harmless NVMTA, his, her or its agents and representatives including the music instructor, from any claims or causes of action arising or related in any respect to the activity or the CHILD’S participation in such activity. Furthermore, I understand that no royalty, fee, or other compensation shall become payable to me by reason of such use. I have read and understand the above.


By entering your name here, the PARENT authorizes NVMTA to undertake that activity on behalf of the CHILD as described above:"

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Name of NVMTA Event
Child's (or children's) full name(s)
Your teacher's name
By entering your name here, the PARENT authorizes  NVMTA to undertake this activity on behalf of the CHILD as described above:
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