Parent/Guardian Name

Parent/Guardian Address

Acknowledgements, Release and Waiver of Liability

For, and in consideration of, my participation in the program, I hereby generally and forever release and discharge, without limitation, and agree not to sue the University of Arkansas and/or its respective officers, employees and agents from and against any and all manner of claims, causes of action, or liability that I may have now or at any time in the future against the University of Arkansas, including without limitation, any faculty or staff members assisting with the program, which may arise out of or relate to any injury (including, but not limited to death), loss, damage or harm of any kind that may result or may happen to me during the time when I am participating in the private lesson program, including any injury (including, but not limited to death), loss, damage or harm which may result from the negligence of the University of Arkansas and/or its respective officers, employees and/or agents.

 I agree to abide by any and all policies and procedures of the University of Arkansas, including any rules and regulations specifically related to my participation in the private lesson program such as the “Student Expectations and Guidelines.” I acknowledge and agree that my intentional or inadvertent failure to abide by any of these rules may result in my immediate removal from the program without notice.

I will at all times follow all safety procedures as directed by the staff, including COVID-19 safety measures. I understand that my participation is voluntary and at my own risk, and I voluntarily assume all risks inherent in the planned activities. I acknowledge that I have notice of the risks inherent in the activities, including, but not limited to, risks involving (i) music production, and (ii) instrument learning. I understand that these activities may result in serious injuries, including but not limited to sprains, strains, cuts, neck injuries, mental distress, fatigue, or bruising. I also acknowledge that, because materials may be mailed to me, there may be a risk, however slight, of transmission of COVID-19 or any other communicable illness from contact with the materials, and I accept that risk.

I agree not to take part in any activities that would represent a danger to me due to health or physical condition, regardless of whether I have disclosed such condition to any officer, agent, or employee of the University of Arkansas. I agree that if I do undertake any such activities, I do so solely at my own risk. 

This Acknowledgements, Release and Waiver of Liability may be in addition to and does not revoke or modify any other agreement or release that I may execute in connection with my participation.

 This Acknowledgements, Release and Waiver of Liability shall be construed and enforced in accordance with the laws of the State of Arkansas, without regard to its choice of law principles.

 I HAVE CAREFULLY READ THIS ACKNOWLEDGEMENTS, RELEASE AND WAIVER OF LIABILITY AND FULLY UNDERSTAND ITS CONTENTS. I ACKNOWLEDGE AND AGREE THAT THIS RELEASE AND WAIVER OF LIABILITY SHALL BE BINDING UPON MY SURVIVORS, HEIRS, SUCCESSORS, AND ASSIGNS. I AM AWARE THAT THIS RELEASE AND WAIVER OF LIABILITY IS A RELEASE OF LIABILITY, INCLUDING BUT NOT LIMITED TO, LIABILITY FOR NEGLIGENCE, AND AN INDEMNIFICATION AGREEMENT, AND I SIGN IT OF MY OWN FREE WILL AS A VOLUNTARY CONDITION OF BEING PERMITTED TO TAKE PART IN THE ACTIVITIES.

If a participant is under the age of eighteen (18) years, this Acknowledgements, Release and Waiver of Liability must be executed by the participant's parent or guardian:

Acknowledgements, Release and Waiver of Liability

For, and in consideration of, my participation in the private lesson program, I hereby generally and forever release and discharge, without limitation, and agree not to sue the University of Arkansas and/or its respective officers, employees and agents from and against any and all manner of claims, causes of action, or liability that I may have now or at any time in the future against the University of Arkansas, including without limitation, any faculty or staff members assisting with the program, which may arise out of or relate to any injury (including, but not limited to death), loss, damage or harm of any kind that may result or may happen to me during the time when I am participating in the program, including any injury (including, but not limited to death), loss, damage or harm which may result from the negligence of the University of Arkansas and/or its respective officers, employees and/or agents.

 I agree to abide by any and all policies and procedures of the University of Arkansas, including any rules and regulations specifically related to my participation in the program such as the “Student Expectations and Guidelines.” I acknowledge and agree that my intentional or inadvertent failure to abide by any of these rules may result in my immediate removal from the program without notice.

I will at all times follow all safety procedures as directed by the staff, including COVID-19 safety measures. I understand that my participation in the program is voluntary and at my own risk, and I voluntarily assume all risks inherent in the planned activities. I acknowledge that I have notice of the risks inherent in the activities, including, but not limited to, risks involving (i) music production and (ii) instrumental learning. I understand that these activities may result in serious injuries, including but not limited to sprains, strains, cuts, neck injuries, mental distress, fatigue, or bruising. I also acknowledge that, because materials may be mailed to me, there may be a risk, however slight, of transmission of COVID-19 or any other communicable illness from contact with the materials, and I accept that risk.

I agree not to take part in any activities that would represent a danger to me due to health or physical condition, regardless of whether I have disclosed such condition to any officer, agent, or employee of the University of Arkansas. I agree that if I do undertake any such activities, I do so solely at my own risk. 

This Acknowledgements, Release and Waiver of Liability may be in addition to and does not revoke or modify any other agreement or release that I may execute in connection with my participation.

This Acknowledgements, Release and Waiver of Liability shall be construed and enforced in accordance with the laws of the State of Arkansas, without regard to its choice of law principles.

I HAVE CAREFULLY READ THIS ACKNOWLEDGEMENTS, RELEASE AND WAIVER OF LIABILITY AND FULLY UNDERSTAND ITS CONTENTS. I ACKNOWLEDGE AND AGREE THAT THIS RELEASE AND WAIVER OF LIABILITY SHALL BE BINDING UPON MY SURVIVORS, HEIRS, SUCCESSORS, AND ASSIGNS. I AM AWARE THAT THIS RELEASE AND WAIVER OF LIABILITY IS A RELEASE OF LIABILITY, INCLUDING BUT NOT LIMITED TO, LIABILITY FOR NEGLIGENCE, AND AN INDEMNIFICATION AGREEMENT, AND I SIGN IT OF MY OWN FREE WILL AS A VOLUNTARY CONDITION OF BEING PERMITTED TO TAKE PART IN THE ACTIVITIES.

Photograph/Video and Data Release

The University of Arkansas would like to use photographs, video recordings, audio recordings, and/or content created in our program that identify or can identify the participant. Photographs, video recordings, audio recordings, and/or content may be captured and/or created during the course of the program.

The personal data described above may be published in the program's web site, social media platforms, future printed materials for the purpose of promoting Community Music School activities. Once published, personal data contained in Community Music School social media platforms and web site may remain public indefinitely.

By signing below, you grant permission for the University of Arkansas to create recordings of the image, likeness, and/or voice of the participant (“Recordings”) in connection with the participant’s involvement in the program.  You agree the Recordings may take the form of photographs, films, video and audio tapes, CD-ROMs, DVDs, digital files, and/or any other media now known or later developed.  The University of Arkansas may use the Recordings at its discretion.  You understand that University of Arkansas’s use of the Recordings may include, but not be limited to, the activities described above.

You understand that neither you nor the participant will be paid for any uses made of the Recordings pursuant to this grant of permission. You waive the right to inspect or approve of the uses of any printed or electronic copy.

You acknowledge that the University of Arkansas exclusively owns all rights to the Recordings, including but not limited to, any copyright or trademark rights associated with the Recordings. To the extent the Recordings include any content created by the participant as part of the program such as drawings, writings, projects, artwork, and other works or creations (“Content”), you, on behalf of participant, hereby grant the University of Arkansas a non-exclusive, perpetual, worldwide, royalty-free, and unlimited license to use, reproduce, distribute, display, and perform, any Content. The University of Arkansas is also granted a non-exclusive, perpetual, worldwide, royalty-free, and unlimited license to create derivative works in any media, now known or later developed, from any Content, and any clips or portions thereof.  The University of Arkansas shall own such derivative works; however, in any instance where the University of Arkansas is deemed not to own such derivative work, you, on behalf of the participant, hereby grants the University of Arkansas a license to the derivative works on terms identical to its license granted above.

You, on behalf of yourself and the participant, hereby waive all rights and release the University of Arkansas from, and shall neither sue nor bring any proceeding against any such parties for, any claim or cause of action, whether now known or unknown, for defamation, invasion of right to privacy, publicity or personality or any similar matter, or based upon or relating to the use and exploitation of the Recordings.

You understand that you are not required to give the above-referenced consents, and you are doing so voluntarily.

You may withdraw your consent at any time by emailing cms@uark.edu.  If you withdraw your consent, we will not engage in the activities described above in the future.  A withdrawn consent will not apply to past personal data processing.

If a participant is under the age of eighteen (18) years, this Photograph/Video and Data Release must be executed by the participant's parent or guardian:

Photograph/Video and Data Release

The University of Arkansas would like to use photographs, video recordings, audio recordings, and/or content created in our program that identify or can identify the participant. Photographs, video recordings, audio recordings, and/or content may be captured and/or created during the course of the program.

The personal data described above may be published in the program's web site, social media platforms, future printed materials for the purpose of promoting Community Music School activities. Once published, personal data contained in Community Music School social media platforms and web site may remain public indefinitely.

By signing below, you grant permission for the University of Arkansas to create recordings of the image, likeness, and/or voice of the participant (“Recordings”) in connection with the participant’s involvement in the program.  You agree the Recordings may take the form of photographs, films, video and audio tapes, CD-ROMs, DVDs, digital files, and/or any other media now known or later developed.  The University of Arkansas may use the Recordings at its discretion.  You understand that University of Arkansas’s use of the Recordings may include, but not be limited to, the activities described above.

You understand that neither you nor the participant will be paid for any uses made of the Recordings pursuant to this grant of permission. You waive the right to inspect or approve of the uses of any printed or electronic copy.

You acknowledge that the University of Arkansas exclusively owns all rights to the Recordings, including but not limited to, any copyright or trademark rights associated with the Recordings. To the extent the Recordings include any content created by the participant as part of the program such as drawings, writings, projects, artwork, and other works or creations (“Content”), you, on behalf of participant, hereby grant the University of Arkansas a non-exclusive, perpetual, worldwide, royalty-free, and unlimited license to use, reproduce, distribute, display, and perform, any Content. The University of Arkansas is also granted a non-exclusive, perpetual, worldwide, royalty-free, and unlimited license to create derivative works in any media, now known or later developed, from any Content, and any clips or portions thereof.  The University of Arkansas shall own such derivative works; however, in any instance where the University of Arkansas is deemed not to own such derivative work, you, on behalf of the participant, hereby grants the University of Arkansas a license to the derivative works on terms identical to its license granted above.

You, on behalf of yourself and the participant, hereby waive all rights and release the University of Arkansas from, and shall neither sue nor bring any proceeding against any such parties for, any claim or cause of action, whether now known or unknown, for defamation, invasion of right to privacy, publicity or personality or any similar matter, or based upon or relating to the use and exploitation of the Recordings.

You understand that you are not required to give the above-referenced consents, and you are doing so voluntarily.

You may withdraw your consent at any time by emailing cms@uark.edu.  If you withdraw your consent, we will not engage in the activities described above in the future.  A withdrawn consent will not apply to past personal data processing.

Communication with Participants under 13
The University of Arkansas would like to use contact information belonging to participants who are under 13 years of age (such as email address, phone number, or mailing address) to send communications relating to announcements, assignments, logistics, mentoring, or similar matters during the program. Please note that certain program activities may rely on communications with participants under 13. Our inability to contact a participant may impact that participant’s experience.

 You may withdraw your consent at any time by sending an email to cms@uark.edu.  If you withdraw your consent, we will not send any communications in the future. A withdrawn consent will not apply to past communications.

Communication about other University of Arkansas Programs with Parents, Guardians, or Participants who are 18+

The program would like to use your registration and contact information (such as name, address, phone number, email address, parent or guardian’s relationship to a participant who is under 18 years of age, program in which participant is involved, etc.) to send communications about other University of Arkansas programs that may be of interest to you.

 You may withdraw your consent at any time by sending an email to cms@uark.edu.  If you withdraw your consent, we will not send any communications in the future. A withdrawn consent cannot apply to past communications.

Recruiting 
The program would like to share

• registration and contact information (such as name, address, email address, phone number, mailing address, program with which the participant is involved, participant’s grade level); and
• background information (such as school, school district, athletic history, athletic achievements, relevant coursework, personal statements, enrollment in past programs, references from a participant’s teachers or coaches)

with relevant University of Arkansas units or departments for recruiting (including to contact parents, guardians, and/or the participant).

You may withdraw your consent at any time by sending an email to cms@uark.edu.  If you withdraw your consent, we will not share any information in the future. A withdrawn consent will not apply to past personal data sharing.