Performer's Name *

First Name

Last Name

Duet Partner's Name (if applicable)

If none, leave blank

First Name

Last Name

Name of Accompanist, if using

if none, leave blank

First Name

Last Name

Does the performer require special accommodations or considerations? (E.g., accessibility, special needs, etc) *

Yes

No

Performer's Teacher *

First Name

Last Name

The students registered on this form agree to abide by the dress code *

I Agree

Media Consent: I consent and authorize MTAC and MTAC Branches to capture, use, reproduce, and distribute images, video, and audio recordings of me, including my musical performance or quoted statements, for promotional and educational purposes. I agree that use of such images and recordingd may personally identify me by name, unless I notify MTAC or MTAC Branches otherwise in writing, and are without any compensation to me. I agree to waive and release any and all claims related to the use of these images and recordings. MTAC owns the sole copyright to the images and recordings taken by MTAC.

I Agree

Privacy Policy: I agree to take video and screenshots of myself only. I understand that I may not share, distribute, or post pictures or videos of any students besides those designated on this form in any public forum, including social media, or privately, and that legal action may be taken to address violations of this policy. *

I Agree