Fraser Valley Métis Association's Fiddle Lessons 2023 - 2024 Registration Package
Saturday classes beginning October 14, 2023 to June 2024 (No class on statutory holidays)
**Also no classes on the following dates** 
December 16 - 30th 2023 (back on January 6, 2024)  
March 23 - April 6, 2024 (back on April 13, 2024)
Bring your own violin/fiddle or rent (King's Music offering discount rental with option to buy)
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First Name *
Last Name *
Date Of Birth
(Provide the participant's date of birth)
 *
MM
/
DD
/
YYYY
Street Address *
City *
Postal Code *
Telephone *
Email *
Métis Nation BC Citizenship #
(Enter if applicable)
Fraser Valley Métis Association Member #
(Enter if applicable)
How did you find out about the fiddle lessons? *
What class are you registering for? *
Does the student/participant have any special instructions we should be aware of? 
If yes please explain.
Health Care Provider *
Health Care Provider Phone # *
Medical Conditions - leave blank if none
Emergency Contact #1 Name *
Emergency Contact #1 Phone *
Emergency Contact #2 Name *
Emergency Contact #2 Phone *
LIABILITY / WAIVER
If I, or the youth in my care, participate in any of the below listed, but not limited to, activities sponsored or organized by The Fraser Valley Métis Association, and partner(s) I understand that in order for FVMA to accept my application to participate in the activities, I must agree to be bound by this Release, Waiver and Assumption of Risk. In entering into this agreement, I am not relying on any oral, written or visual representations or statements made by the Released Parties, including those in any advertisement or other communications, to induce me to participate in the activity.

Possible Activities: PERSONAL DEVELOPMENT WORKSHOP(S), JIGGING, VIOLIN LESSONS, COMMUNITY GATHERING OR FUND DAY ACTIVITIES, CONSUMPTION OF PROVIDED MEALS OR SNACKS, TRANSPORTATION TO OR FROM ACTIVITIES WHEN PROVIDED, AND ANY AND ALL OTHER ACTIVITIES

I waive any and all claims, I may now and in the future
have against, and release from all liability and agree not
to sue The Fraser Valley Métis Association, or any other
participating partnering association, and/or their board of directors, officers, employees, facilitators, instructors, leaders (volunteer or other), agents or representatives (collectively the “The Releases Parties”) for any personal injury, death and property damages, expenses or loss sustained by me as a result of my participation in the above activities due to any cause whatsoever, including, without limitation, negligence, breach of statutory duty including duties arising from occupier’s liability legislation, on the part of the Released Parties. 

I agree that I will be fully responsible for all costs and expenses which may be incurred in providing any special services to me, outside of regular services agreed to or provided by the Released Parties in connection with the activities, and without limiting the generality of the foregoing.

I agree to be responsible for and to pay for all and any costs of rescues, special travels, medical attention or other special outlay for myself personally, and to reimburse the Released Parties and its staff or volunteers for all costs of these services as may be incurred by them for my benefit or at my request. I confirm that I am the full age of majority or, in the alternative, I have indicated agreement prior to signing it and agree that this agreement will be binding upon me (as participants or guardians), my heirs, next of kin, executors, administrators and successors.  

(Select One) 

If participant is under age of 19 years - Select "Other" and enter: FULL PARENT/GUARDIAN NAME

 *
Required
PARENT/GUARDIAN PARTICIPATION CONSENT
As Parent/Guardian of participant I hereby grant permission to participate in the Fraser Valley Métis Association (FVMA) workshop.
FVMA reserves the right to refuse further participation to any participant for inappropriate behaviour.
I understand participation in the FVMA workshop may expose my child to unanticipated risks in the program.
I acknowledge that FVMA will not be responsible for injury, loss or damage to my child or my child’s property.
I am aware that the risks to my child may include but are not limited to the following:
(a) loss or damage to personal property;
(b) physical or emotional injury;
(c) my own failure or that of other participants to follow the safety guidelines; and
(d) negligence of other participants.

(Select One)
 *

PARENT/GUARDIAN MEDIA CONSENT

I authorize the Program run by the FVMA to video or photograph my child. FVMA may use and re-use all or parts of the video or photograph. They shall own all right, title and interest in and to the video or photograph including the recordings, to be used and re-used and disposed of without limitation in any media or form of distribution as the FVMA may solely determine.

(Select One) *
Do you have any questions, suggestions, or feedback for FVMA or the fiddle lessons?
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