Student Information

Parent / Legal Guardian Information (1)

Parent / Legal Guardian Information (2)

Emergency Contact Information

(Not a Parent or Guardian - Parent/Guardian will always be called first)

Release of Liability

I acknowledge that I am voluntarily participating in the San Diego Civic Youth Orchestra (CYO) program and will attend and participate in all events being organized by CYO as part of their program. I acknowledge that participation in this program is entirely voluntary. I hereby understand, acknowledge, and agree as follows:

I VOLUNTARILY ACCEPT AND SOLELY ASSUME FULL RESPONSIBILITY FOR ALL RISKS OF DAMAGES, LOSSES, INJURIES, OR DEATH INCURRED OR SUFFERED by myself or my property while participating in the CYO program and while attending or participating in events organized or allowed by CYO.

By signing this form, I AGREE NOT TO HOLD CYO, ITS OFFICERS, DIRECTORS, EMPLOYEES, AGENTS, VOLUNTEER STAFF, AND CHAPERONES, AND EACH OF THEIR SUCCESSORS AND ASSIGNS LIABLE FOR DAMAGES, LOSSES, INJURIES, OR DEATH incurred or suffered during this program, even if such damages, losses, injuries, or death are a result of the negligence of CYO or other participants of CYO. I WAIVE, RELEASE, AND FOREVER DISCHARGE CYO, its officers, directors, employees, agents, volunteer staff, chaperones, and each of their successors and assigns FROM ANY AND ALL LIABILITIES, CLAIMS, DEMANDS, OR CAUSES OF ACTION WHATSOEVER resulting from, arising out of, or in connection with this program.

I ACKNOWLEDGE THAT I HAVE READ, UNDERSTAND, AND AGREE TO EACH AND EVERY PROVISION IN THIS RELEASE OF LIABILITY AND AM VOLUNTARILY SIGNING THIS RELEASE OF LIABILITY ON BEHALF OF MYSELF.

Media Release Form

Pursuant to the furtherance of the purposes, goals and objectives of the San Diego Civic Youth Orchestra, its officers and employees are hereby granted permission to use photographs and video or audio recordings of the student listed above.

In granting the above permission, I hereby relinquish all rights, title or interest in the above mentioned photographs and/or recordings. Additionally, I hereby grant San Diego Civic Youth Orchestra, its officers, employees, and licensees permission for reproductions, uses or publications of photos and/or recordings. Additionally, I release Civic Youth Orchestra, its officers, employees, and licensees from any and all claims, that musician may now have for libel, defamation, invasion of privacy or right of publicity, infringement of copyright or violation of any other right arising out of or relating to any utilization of the photos and/or recordings.