Community Piano Lab Application and Waiver Form

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Community Piano Lab Application and Waiver Form - Beginner

Email *

Student's First Name *

Student's Last Name *

Age *

Birthday

Parent's Full Name *

Telephone Number *

Home Address

Please summarize your child's background and exposure to music (parents/siblings play musical instruments, children's choir, etc.,). *

Please summarize your child's experience with the piano. If your child has taken piano lessons before, include names of method books and solos. *

Will your child be able to practice 30 minutes a day? *

Yes, often

Not often

Will you be able to supervise your child's practice at home and ensure that he or she accomplishes their teacher-given assignments? *

Yes

Occasionally

Waiver - Agreement and Release Form

I desire that my child participate in, and receive the benefits of, BYU-Idaho’s Community Piano Lab. In consideration of BYU-Idaho accepting my child for participation, I agree and affirm the following on behalf of myself and my child:

I hereby give consent for my child/children to be recorded in audio and/or visual formats for academic uses in the Piano Teaching practicum courses associated with the Community Piano Lab (MUS 265, MUS 363A/B and MUS 491). Any such recordings (photographs, video, sound recordings, etc) will be used by BYU-Idaho for academic evaluation only. I hereby waive the right to inspect or approve the finished recordings and/or publications used. *

Yes

I acknowledge that there are inherent risks and danger of injury, property damage, and illness present on a university campus and in university programs, and I assume all those risks as to my child. These risks include, but are not limited to, accidental injury, loss of property, and illness. *

Yes

I covenant on behalf of my child, myself (and my spouse, my heirs, and successors if any) that no claim shall be brought against BYU-Idaho or its employees, students, agents, officers, board or volunteers (“BYU-Idaho”). I hereby waive any and all claims, including but not limited to personal injury or property damage, resulting from participation in this program; I release BYU-Idaho from any such claim which may arise even if caused by the negligence of BYU-Idaho; and I further covenant and agree to indemnify and hold harmless BYU-Idaho from any claim arising out of the actions of or injury to my child in connection with the program.

Yes

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