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Annual Community Music Ministry

Register to participate in our Annual Community Music Ministry

Space is Limited

Deadline to Register is Saturday, November 2, 2019

Music On Wheels Academy students have the opportunity to give back to the community by performing musical selections for residents
Please indicate where your/your child's music lesson is being held.
It is the responsibility of parent/guardian to check e-mail and our website for updated information.
As a parent and student, I hold Powder Springs Transitional Care and Rehab and Winnwood Retirement Community harmless against any and all liability claims, judgments or damages arising as a result of participating in this community event program. This community event has inherent risks for student injury and as the parent, I acknowledge and assume the responsibility of potential injury to my child(ren). I waive, release and discharge from any and all liability, including but not limited to liability arising from the negligence or fault of the entities or persons released: Music On Wheels, and /or their directors, officers, employees, volunteers, representatives, and agents, the activity or event holders, sponsors, or volunteers. I indemnify, hold harmless, and promise not to sue the entities mentioned in this paragraph from all liabilities and claims resulting from participation in classes, lessons, events, or activities due to negligence, errors, omissions, acts, or failures to act of any party or entity conducting services, activities, or events on behalf of Music On Wheels, LLC. I acknowledge that this activity or event may involve a test of a person’s physical and mental limits and may carry with it the potential for serious injury, property loss, or death. Risks may include, but are not limited to, those caused by terrain, facilities, temperature, weather, health condition of participants, equipment, vehicular traffic, actions of other people including, but not limited to, participants, volunteers, spectators, coaches, event officials, and event monitors, and/or producers of the event, and lack of hydration. These risks are not only inherent to participants, but are also present for staff. I understand that risk of injury is inherent in any physical activity, and I, on behalf of myself/my child, knowingly and voluntarily accept that risk that may include but is not limited to heart, back, medical, allergy, muscular, pregnancy, diabetes, epilepsy, chemical or neurological condition, special medication, knee/kidney/shoulder problems, etc. I further certify that the aforementioned student is in proper physical condition to participate in the exercise/dance program and that he/she has been examined by a licensed physician and found to be in proper physical condition to participate in the Music On Wheels program. I hereby consent my child to receive medical treatment, which may be deemed advisable in the event of injury, accident, and/or illness during this class, activity or event. I understand that I am responsible for any medical expenses and that the absence of health insurance does not make Music On Wheels, LLC responsible for payment of medical expenses. The accident waiver and release of liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. I also understand that at this event or related activities, my child may be photographed or videotaped in activities described within Music on Wheels’ program. I agree to allow photos, video, Internet advertisement, and/or film to be used for any legitimate purpose by the event holders, producers, sponsors, organizers, for marketing, informational, or educational purposes. I CERTIFY THAT I HAVE READ THIS DOCUMENT, AND I FULLY AGREE AND UNDERSTAND ITS CONTENT. I have also received the Parent/Student Enrollment Handbook and I understand that I am responsible and accountable to the information enclosed. I give my child permission to participate in the Music On Wheels Program under the guidelines set forth in the Parent/Student Enrollment Manuel, and this entire form regarding payment, liability waiver, and release of Photography and video.
I give permission for my child to participate in the Annual Community Music Ministry described below.
Powder Springs Transitional: 3460 Powder Springs Rd, Powder Springs, GA 30127. On Saturday, January 11, 2020 (instrumental students report at 9:30 am). Begins at 10:00 a...................... Canterfield of Kennesaw: 4381 Bells Ferry Rd, Kennesaw, GA 30144. On Saturday, January 18, 2020(instrumental students report at 9#30 am). Begins at 10:00 a...........................