Emergency Contact and Waiver Form 2018/2019

Emergency Contact and Waiver Form 2018/2019

For participation in all programming at and through 171 Cedar Arts Center.

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1.MEDICAL RELEASE Emergency Medical Information: The staff of 171 Cedar Arts Center works to ensure the safety of you and/or your children as you/they participate in classes/instruction/programs. However, if a student were to become ill or injured while attending classes/instruction/programs, we must have the names and working phone numbers for relatives or friends with available transportation who can pick up and ensure that the student receives appropriate medical care. Please complete the section below.(By default, we reserve the right to use the e-mail address listed below to update the student, or responsible adult, about class cancellations, schedule changes, new classes and events, and other important announcements via our e-newsletter. You may unsubscribe electronically at the bottom of the e-newsletter as it appears in your e-mail.)

Emergency Contact and Waiver Form

This form is required to participate in all programming, classes, workshops, and private music lessons offered at or through 171 Cedar Arts Center. Questions? Ann.Recotta@171CedarArts.org