12 hours of instruction | was $788 4 Fun Days — Only $197! Summer Sing Enrollment FormHow did you hear about Freedom Music Academy? *Today's Date *Student Name *Student Birthdate *Male / Female *MaleFemaleParent/Guardian Name *Home Address *Apartment, suite, etcCity *State *ZIP / Postal CodePrimary Contact Phone Number *This number will receive lesson reminders and scheduling updatesEmail Address *Emergency Contact InformationEmergency Contact #1 *Relationship *Home Phone *Cell PhoneWork PhoneEmergency Contact #2 *Relationship *Home Phone *Cell PhoneWork PhonePhoto & Audio/Video Recording WaiverFreedom Music Academy often records videos and takes photographs of student’s lessons and/or performances for the purposes of teaching, progress reports, and/or advertisement on F.M.A. websites or social media accounts. We also record and photograph recitals and post on YouTube and websites.Radio *Yes, I give permission for the image, audio and or video recording of my child, to be used by the Freedom Music Academy LLCNO, I do NOT give permission for the image, audio and or video recording of my child, to be used by the Freedom Music Academy LLCSign here after completing the Image & Audio/Video Recording Waiver *Start signing your signature hereYour browser does not support e-Signature field.TUITIONAll payments are processed by pre-authorized credit cards or auto-draft from checking accounts on the first of the month. Summer Singing Camp is a 4 day, 3 hours per day summer camp for vocalists. The cost is $197/student. There are no discounts for days missed. Cost includes any teaching materials and handouts made available throughout camp.Click to indicate that you understand and accept.CANCELLATIONS AND MAKEUPSThere are no refunds or makeups available for missed lesson days during the Summer Singing Camp at Freedom Music Academy.Click to indicate that you understand and accept.STUDENT CAREThe school is not responsible for providing before or after care for students. Parents with children under the age of eight must remain in the school lobby during the classes. Students are not to be left at the school for excessive time periods before or after their lessons.Click to indicate that you understand and accept.OPEN DOOR POLICYParents are always allowed to sit in on lessons. We have an open-door policy for lessons.Click to indicate that you understand and accept.INJURIESParents, legal guardians of minors, students and adult students waive the right to any legal action for any injury sustained on school property resulting from normal lesson activity or any other activity conducted by the students or their siblings before, during, or after lesson time, including hearing loss or hearing damage. The Freedom Music Academy is not responsible for any damage done to vehicles or items stolen from vehicles.Click to indicate that you understand and accept.STUDENT PICK UPChildren must wait for their parents to pick them up inside the Academy. Please do not ask them to meet you elsewhere. Students are not to be dropped off on the street or curb. The Academy assumes no responsibility for children who leave unaccompanied.Click to indicate that you understand and accept.Sign here that you have read, understand, and agree to abide by these policies: *Start signing your signature hereYour browser does not support e-Signature field.Authorization Agreement for PaymentPayment for camp are withdrawn from your bank immediately for a one-time payment of $197 (or discounted amount if applicable).(I/We) do hereby authorize the FREEDOM MUSIC ACADEMY, LLC, hereinafter named the COMPANY, to initiate recurring (debit or credit) entries to (my/our) (Credit Card Account) as indicated and named below as the depository financial institutions, hereafter named FINANCIAL INSTITUTION. (I/We) acknowledge that the origination of ACH transactions to (my/our) account must comply with the provisions of U.S. law. Furthermore, if any such debit(s) should be returned NSF, (I/we) authorize the COMPANY to collect such debit(s) by electronic debit and subsequently collect a returned debit NSF fee of $25.00 per item by electronic debit from my account identified below, and authorize all of the above as evidenced by my signature below. This authorization is to remain in full force and effect until the COMPANY has received written notification from me (or either of us) of its termination in such time and in such manner as to afford the COMPANY and FINANCIAL INSTITUTION a reasonable opportunity to act on it. I have read and understand the FMA policies and procedures and payment authorization agreement and agree to abide by them. Sign here after reading policies, payment authorization and waivers. *Start signing your signature hereYour browser does not support e-Signature field.Credit / Debit Card *Send Message
