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

Parent/Guardian *

First Name

Last Name

Phone *

(###)

###

####

Performer's Teacher *

First Name

Last Name

Parent/Guardian Consent: As Parent/Legal Guardian of my child, I give my full consent and approval for my child to participate in the programs and activities of the MTAC and MTAC Branches (MTAC / Branch Program(s)) *

I agree

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 my child, including his/her musical performance or quoted statements, for promotional and educational purposes. I agree that use of such images and recordingd may personally identify my child by name, unless I notify MTAC or MTAC Branches otherwise in writing, and are without any compensation to me or my child. 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 my child 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