Registration form

Impa 2005 Summer Release Form : Orchestra

You must fill out both the Release form and the Registration form. Failure to do so will jeopardize you participation).

I,_____________________,(SS number) ____________________________will be participating in a Summer Seminar organized by the Institute Musical de Provence-Aubagne, and will be transported during such event by way of student driving, by riding in a private vehicle, or by way of hired vehicles.
In consideration of being permitted to participate in said Seminar, I, the undersigned, in full recognition and appreciation of the dangers inherent in domestic and international travel to which I may be exposed during my participation in said Seminar, do hereby agree to assume all risks of and responsibilities for activities undertaken an adjunct thereto; and, further, I do for myself, my heirs, and personal representative(s) hereby defend, hold harmless, indemnify, and release, and forever discharge the Institute Musical de Provence-Aubagne and all it officers, agents and employees from and against any and all claims, demands and actions, or causes of action account of damage to personal property or personal injury, or death, which may result from my participation, and which result from causes beyond the control of, and without the fault or negligence of the Institute Musical de Provence-Aubagne, its officers, agents or employees, during the period of my participation as aforesaid.
It is further understood that I will act in accordance with the policies and guidelines set forth in the guidelines provided. Failure to comply with these policies and guidelines will result in canceling immediately my participation the Seminar with no refund of any sort.
NO SUPERVISION OF MINORS UNDER 18 WILL BE PROVIDED OUTSIDE OF THE REHEARSAL SESSION
The Legal Age in France is 18.

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Signature of Seminar Participant

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Signature of Legal Guardian for Participant under 18 years of age

 Registration form

Impa 2005 Summer Registration Form : Orchestra

Mr./ Ms ....................................................................................................................
Last Name and First Name

Date / Place of birth.............................................................................................

Address....................................................................................................................

..................................................................................................................................

Phone, Fax, and E-mail ..........................................................................................

Iinstrument .................................................... Teacher.........................................

School .................................................... Grade Level.........................................

Do you play in an ensemble ?...................................................................................

Rules and Regulations:

I agree to comply with the rules of the Seminar.

I have full insurance coverage for myself and my instrument.

I have an International Student ID.

I am responsible for my own travel arrangements and expenses.

NO SUPERVISION OF MINORS UNDER 18 WILL BE PROVIDED OUTSID OF THE REHEARSAL SESSIONS.

The Legal Age in France is 18.

Cancellation fee: after May 1st, $300; After June 1st, $500.

....................................................................................................date ......................
Signature of Seminar Participant

............................................................................................ ......date .......................
Signature of Legal Guardian for Participant under 18 years of age