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2022-2023 Digital iPad Music CAC

2022 - 2023 Digital iPad Music

1. Name and Address
This question requires a valid email address.
3. What is your Race/Ethnicity? Check all that apply (for grant reporting purposes) *This question is required.
  • * This question is required.
5. Would you like to share your student's disability? *This question is required.
6. Has the student used a digital music program before? *This question is required.
7. Will your student have access to an iPad with good WI-Fi connection? *This question is required.
– $30.00
8. Will your student have access to the following devices? Please check all that apply *This question is required.
9. Can your student navigate a computer independently? *This question is required.
10. Are you able to help your student with any accommodations/modifications to successfully participate? *This question is required.
11. Will your student be participating with a personal assistant? *This question is required.
12. Where did you hear about this program?  Please select all that apply. *This question is required.
13. Release of liability, waiver of claims, assumption of risks, indemnity agreement, and media release
Please check the appropriate box below indicating you agree or do not agree with the statement. Please note- your child will NOT be able to participate in the camp if you check "I do not agree" to items 1 or 2. *This question is required.
1) Release of liability- 
I agree to the following release of liability as a participant or parent/guardian of a participant in an in-person and/or online program with Arts4All Florida. In the case of any injury to registrant associated with an activity involving Arts4All Florida, the registrant shall indemnify and hold harmless, and hereby release, discharge, and acquit Arts4All Florida (and their respective directors, officers, members, employees, agents, teaching artists, and independent contractors) from and against any and all claims, damages and liabilities resulting from or associated with said injury or the treatment of said injury. By checking "I agree" and signing this in the area below release, I acknowledge I have read and fully understand this agreement and intend my signature to be an unconditional and complete release of all liability. I also acknowledge that my electronic signature has the same force and effect as an original signature. *This question is required.
2) Permission for virtual learning-
I agree to allow my child to use Zoom as a tool for virtual learning. 

I understand that live virtual learning is not pre-recorded and that anything stated or exposed during the virtual learning session can’t be edited before the student witnesses the content. I understand that my child's image may be transmitted during video portions of this program. I also understand that these sessions may be recorded by staff for student/parent review purposes at a later time. I understand that, if at any time I would like my child to be removed from the virtual class, I will email Jennifer Sabo at jsabo@usf.edu.  *This question is required.
3) Media release-
I hereby give consent to Arts4All Florida to use my/my child's first name, photo, voice, or other likeness that is included in virtual programming as well as artwork created in the program for future public awareness including print media, online news distribution, Arts4All Florida website, television and radio opportunities, video, promotional materials and other similar mediums (the "Production"). Such use of the Production is permitted throughout the world or exhibition purposes by Arts4All Florida in whatever manner it may desire, and may be copied, copyrighted, edited and distributed by Arts4All Florida in any medium in perpetuity without any compensation to me.  Furthermore, I consent that any such Production shall be the exclusive property of Arts4All Florida and Arts4All Florida shall have the right to use, sell, publish, print, display, distribute, duplicate, reproduce, reprint, create derivative works, and make other uses of such Production as Arts4All Florida may desire, free and clear of any claims whatsoever on my part. 
  *This question is required.
14. By signing this release, I acknowledge I have read and fully understand the policies above and have selected "I agree" or "I do not agree" for each one. I acknowledge that my electronic signature has the same force and effect as an original signature. *This question is required.
Clear
Signature of
15. This program is provided free of charge thanks to the generosity of our donors and sponsors. If you would like to make a donation, this will help us continue providing accessible programs for you and other students. Thank you in advance!
THANK YOU FOR YOUR PURCHASE. A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL-FREE (800-435-7352) WITHIN THE STATE. REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL, OR RECOMMENDATION BY THE STATE. OUR REGISTRATION NUMBER IS CH8088.
  *This question is required.
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