Cider Hill Music with Alicia Sign Up

Please Select an available class *

Parents Name

First NameLast Name

Name of student(s) participating

Email

example@example.com

Phone Number (incase of cancelations due to storm weather)

Please enter a valid phone number.

Waiver:

I, ________________________ understand that Alicia Catalano is not liable for
any injuries/accidents on or off Cider Hill Farm Amesbury. I hereby acknowledge, appreciate, and agree to and is fully aware of the risks and hazards in participating in any activities during Alicia Catalano’s music classes and further agrees to the
following:
Alicia Catlano is not responsible for loss/damage or theft to/of your property.
In addition, if I observe any hazard during our participation, I will bring it
to Alicia Catalano(Instructors) attention. I also understand that I may be
denied and asked to leave the class in the event that an employee
feels my child, minor,myself, or caregiver is visibly sick. Please do not
attend if your child is visibly sick.
By signing below, I hereby acknowledge that if an injury occurs to my child or
parent/caregiver, Alicia Catalano will NOT be responsible and is not liable for
any child or caregiver present.
THE UNDERSIGNED HEREBY WAIVES, DISCHARGES AND COVENANTS NOT TO SUE Alicia
Catalano, employees,volunteers, and owners.
This waiver and release shall be binding and apply to ALL risks, known and
unknown, even if resulting from negligent actions of other guests attending the
class.
The fullgoing document is intended to be as broad and inclusive as is permitted
by the laws of the State of Massachusetts.

I understand that ALL sales are FINAL. There are no refunds or class tranfers once a payment is made.

Photo Release:I, for myself, my child, ward or The Minors named in this document, consent to the publication of personal pictures or videos which may be taken by Alicia Catalano or other parents. Publication may include but not limited to marketing materials, social media, and websites.*

Yes, I give permission for my child to be photographedNo, I do not give permission for my Child to be photographed

I would like to receive emails from Music with Alicia on upcoming events, classes, and info!

Signature*

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My Products

Music with Alicia (select number of children below) Each child is $10/class. Please enter quantity for amount of students will be attending in your party. All sales are final, no refunds or class transfers once payment is made.

$10.00 Quantity
Item subtotal:$0.00

Total

$0.00

Payment Methods

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Form

Music with Alicia

Payment Methods