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This Form cannot be submitted until the missing
fields (labelled below in red) have been filled in
"Tastisions Spooktacular" 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?
---Select---
2
3
4
Please list siblings names and ages
FOOD ALLERGIES - If your child has allergies please list)*
CAMP DATE*
Monday, October 12 (9:00am - 3:00pm)
Do you authorize other adults to pick up your child?*
---Select---
YES
NO
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?*
---Select---
YES
NO
FOOD ALLERGIES DISCLAIMER*
I UNDERSTAND that if special items need to be purchased in order to substitute on menu due to allergies that I WILL BE RESPONSIBLE for paying and bringing in those items as the menu is set before the date of camp so any menu changes due to allergies are my responsibility to pay for.
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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