Chamber Music Madness · Solo & Ensemble Prep Workshop 2023

Orchestra Teacher

Name of the school teacher responsible for the ensemble.

Teacher Name

First Name

Last Name

School

Name of the school attended by the ensemble.

Student Contact Information

Name

*

First Name

Last Name

Address

*

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Email

Verify Email

Phone

*

Year of High School Graduation

*

Parent or Guardian

For students under age 18, we require a parent or guardian to complete this registration form on behalf of the student.

Parent or Guardian Name

First Name

Last Name

Parent or Guardian Address (if different from above)

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Parent or Guardian Email

*

Verify Email

*

Parent or Guardian Phone

*

Preferred Contact Method

Student Email

Student Phone

Parent or Guardian Email

Parent or Guardian Phone

Instrument

*

Ensemble

Name of the ensemble (if any) and names of the other student members of the ensemble.

Primary contact person for ensemble

Name, email, and phone number of the person responsible for communication regarding the workshop.

Waivers & Release

We require the following waivers and release.

For student under age 18, we require a parent or guardian to complete this registration form on behalf of the student. The waivers, acknowledgements and release below all refer to your student under age 18.

Instrument Loss or Damage Waiver

*

I understand that I must provide my own insurance for my instrument(s). Chamber Music Guild is not responsible for any loss or damage to my musical instrument(s).

Photography/Recording Waiver

*

Photographs and audiovisual recordings may be taken during the workshop, including but not limited to digital screenshots and performance captures.

I give permission to Chamber Music Guild to use these images of me for promotional purposes, including use in various publications and on their website.

I do not give permission to Chamber Music Guild to use these images of me for promotional purposes, including use in various publications and on their website

Covid-19 Vaccination Acknowledgement

*

I understand that Chamber Music Guild requires all participants to complete a Covid-19 vaccine primary series plus at least one booster dose at least two (2) weeks prior to the workshop. I agree to present my proof of vaccination at the workshop onsite check-in.

COVID-19 Illness Safety Plan Acknowledgement

*

I understand that Chamber Music Guild will follow the Washington State Department of Health Covid-19 guidelines in effect for King County. Recommended preventive measures may include mask-wearing.

Covid-19 Monitoring & Attestation

*

I agree to self-monitor for signs and symptoms of Covid-19 illness during the 2 weeks prior to and during the workshop.(symptoms may include fever, new loss of taste or smell, cough, and shortness of breath). I understand I will be asked to attest to the absence of any of these symptoms at the time of on-site check-in and to notify Chamber Music Guild if I have a positive Covid test within 5 days after attending the workshop.

Covid-19 Illness & Injury Acknowledgement

*

I understand the contagious nature of the Covid-19 virus. I voluntarily assume the risk that I may be exposed to Covid-19 by participating in workshop activities, and that exposure as a vaccinated person may result, rarely, in infection with associated personal injury, illness, permanent disability, and death. I understand that this Covid-19 risk may result from the actions, omissions, or negligence of myself, Chamber Music Guild, and others.

General Illness and Injury Waiver & Release

*

I accept sole responsibility for any injury to myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense of any kind, that I may experience or incur in connection with my participation in the workshop activities. I hereby release, covenant not to sue, discharge, and hold harmless Chamber Music Guild, its board, staff, and volunteers, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto.

Tuition Information

Student registration and ensemble payment due by January 20th, 2023.

Single tuition payment per ensemble is required.

Payment Options

*

I will pay online (see below)

Another ensemble member will pay

I will mail a check to CMG

Other (please add note below)

Note

Add any notes on payment arrangements that we need to know. If you are not the person making the payment, please include the name of the person who will be.

Tuition for Ensemble

$200 - online payment