October_Fest

PAYMENT OPTIONS &

REGISTRATION FORM BELOW

VENMO NOW ACCEPTED - Search for Joanna Crews or @opmi-lessons

CASH APP NOW ACCEPTED - Joanna Crews or $opmimusic

Single Registration - $40

Single Registration with 1 Sibling - $65 ($40 + $25)

Single Registrations + 2 Siblings - $90 ($40 + $25 + $25)

"October Fest" Registration

Please note that all fields followed by an asterisk must be filled in.

Parent/Guardian First Name*

Parent/Guardian Last Name*

E-Mail Address*

Street Address*

City*

Cell Phone*

Child's Name*

Age*

Are you signing up siblings?*

	YES
	NO

If you are signing up siblings, how many children in total will participate?

Please list siblings names and ages

FOOD ALLERGIES - If your child has allergies please list)*

CAMP DATE*

Friday, October 30th (9:00am - 3:00pm)

Do you authorize other adults to pick up your child?*

Additional Authorized Child Pick Up (Please list names, phone numbers, and relation to the child)

Do you authorize OPMI to use photos of your child on our website and/or promotional material?*

FOOD ALLERGIES DISCLAIMER*

I UNDERSTAND that Halloween candy and treats will be handed out so if children have allergies please list in allergy section. I UNDERSTAND that if my child is NOT allowed Halloween treats then I must notify OPMI and I AM RESPONSIBLE for bringing in my own treats for my child if needed.

OPMI Terms and Conditions*

I understand that this program runs from 9am - 3pm. Pick up is 3pm and if picked up after 3:10pm then late fees will be applied. Please do not bring your child if they are sick. We will not allow children that are sick to be dropped off; any child that becomes ill during the program will need to be picked up as well. I have read and agree to the OPMI Terms and Conditions regarding payments and cancellations.

OPMI Payment Policy*

I understand Payments are due the Monday before event and if paid after you will be subject to withdrawal and late registration fees. I understand REGISTRATION DEADLINE is 3 days before event and if you sign up after deadline, late fees will be applied for each child you register. I understand that there are no refunds or credits if you cancel the week of the event, supplies and materials are already purchased.

OPMI Liability Waiver*

BY CHECKING THIS BOX, I AGREE THAT I HAVE READ AND VOLUNTARILY SIGNED THIS AGREEMENT ELECTRONICALLY and further agree that no oral representation, statements, or inducement apart from the following written agreement has been made: IN CONSIDERATION, of being permitted to utilize the facilities, services and program of ORLANDO PREMIER MUSIC INSTRUCTION, herein after referred to as 'OPMI', for any purpose, including, but not limited to observation or use of facilities or equipment, or participation in any off-site program affiliated with OPMI, the undersigned, for himself or herself and any personal representatives, heirs, children and next of kin, hereby acknowledges, agrees and represents that he or she releases OPMI and its staff members from all liability for an injury, loss or damage connected in any way whatsoever to participation in OPMI activities whether on or off of the premises affiliated with OPMI. He or she understands that this release includes any claims based on negligenc

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"October Fest" Registration

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