Registration

Parent/Guardian Information

Student Information

Date of Birth


Class Selection

  Prelude Strings (Beginning)
  Intermezzo Strings (Intermediate)
  Sinfonia Strings (Advanced)

Tuition

Amount
$210
Type

Payment Option
Semester
50%/50%
Payment Due
$210


  I have read and accept the terms of the Southwest Music Academy Participation Release.
(Click or tap here for a copy.)

Override Total
Numbers only (decimal point okay)



    

Southwest Music Academy
Participation Release

By completing and submitting this on-line registration on behalf of my minor child (student named on this registration), I hereby give permission for my child to participate in the Southwest Music Academy programs indicated in this registration (“SWMA Programs”). I hereby warrant that both myself and my child are familiar with the risks associated with participation in SWMA Programs. I acknowledge that my child’s participation in SWMA Programs is wholly voluntary and is not part of the regular school curricular program. I hereby agree and consent to my child’s participation in the SWMA Programs and do assume all risks and hazards which are conducted as part of the associated activities.

I hereby release, absolve, indemnify, and hold blameless the Southwest Music Academy, Inc., its officers, directors, employees, contracted employees, independent contractors, instructors, agents, organizers, and volunteers of any and all liability for damage, injury, or expense of any kind arising out of or connected with my child’s participation in SWMA Programs. I understand that in case of a medical emergency, my own personal medical plan will be used. As a condition of participation in the SWMA Programs by the student named in this registration, I acknowledge that I have read this consent form, and knowingly, on behalf of my child, assume all of the risks associated with participating in any way in the SWMA Programs.

As consideration for being permitted to participate in the SWMA Programs, I hereby agree that I, my assignees, heirs, distributes, guardians, and legal representatives will not make claim against, sue or attach the property of the Southwest Music Academy or the The Las Cruces Public Schools, or any of either’s Affiliates or the supplier of any of the equipment used in these activities for injury or damage resulting from negligence, failure of care, omission or other acts, howsoever caused by an employee, agent or contractor of the Southwest Music Academy or The Las Cruces Public Schools and any of either’s affiliates as result of incidental to my child participation in these activities. I hereby release, to the fullest extend permitted by law, the Southwest Music Academy and The Las Cruces Public Schools and either’s affiliates, from any and all actions, claims, demands, or liabilities that I, my assignees, heirs, distributes, guardians, and legal representatives now have or may hereafter have for injury or damage resulting from my minor child’s participation in SWMA Programs irrespective of whether the same is based on breach of warranty, negligence, strict liability or any other theory or recovery.

I understand that as part of my minor child’s participation in SWMA Programs, photos, videos, electronic images, audio recordings and quotations of my minor child may be taken for use in publications and reports about the program. I hereby grant permission for Southwest Music Academy to use such materials of the program.
Rev 130819

Close