Please complete this form to enroll your child in AMI programming. All information is kept confidential and used to ensure your child's success and safety.

Student Readiness & Support Needs

 

Parent/Guardian Contact Information

I, the undersigned, affirm that I am the parent or legal guardian of the minor listed

below and that I have full legal authority to provide consent for their participation in

the American Music Initiative (“AMI”) after-school program and all related events or

activities. By signing this document, I acknowledge that I have read, understood, and

agreed to the accident waiver and release of liability described earlier in this packet,

and I voluntarily accept its terms on behalf of my child.

I further agree to defend, indemnify, and hold harmless each of the individuals,

organizations, and entities identified in that waiver from any and all liability, claims,

losses, or damages, including attorney’s fees and costs, that may arise as a result of

my child’s participation. This includes any claims that might result from my own lack

of capacity to act on my child’s behalf or from any misrepresentation of my authority

as their parent or guardian.

I understand it is my responsibility to keep the emergency contact information below

up to date and to notify AMI immediately if any changes occur during the school

year.

For the safety of all participants, AMI requires that parents/guardians provide a complete list of all individuals authorized to pick up their child from program activities. This list must include each person’s full name as it appears on a valid photo ID, along with a working contact phone number.

If a person who is not listed below will be picking up my child, I understand that I must contact AMI staff in advance either in writing, by email, or through a personal phone conversation to authorize the release. AMI will not release my child to an individual who is not listed or authorized.

MEDIA RELEASE - PARENTAL CONSENT FORM

Throughout the school year, your child may be photographed, recorded on video, or interviewed while participating in AMI classes, rehearsals, concerts, field trips, and other related events. With your permission, these photographs, video recordings, and/or interviews may be used for promotional or informational purposes by AMI

Such uses may include, but are not limited to:

- Local, regional, or national newspaper articles.

- Program brochures, flyers, or other printed materials.

- Broadcast or cable television features.

- Online publications, including the AMI website.

- Social media platforms such as Facebook, Instagram, YouTube, and others managed by AMI.

I understand that by granting permission, I am authorizing AMI to use such materials without requiring additional consent, without compensation, and without time or geographic restrictions.

Activity Description: Walking between my home (or designated location) and American Music Initiative ("AMI") classes, rehearsals, performances, field trips, and/or

By signing this form, I grant permission for AMI staff to release my child to walk home without adult accompaniment following the completion of AMI-related activities. This includes walking home after daily classes, concerts, special events organized by AMI, or trips to and from event sites.

I understand that by authorizing this, I am accepting full responsibility for my child's safety during travel and acknowledge that the route and conditions are outside the supervision or control of AMI once my child has left the program location.

I understand and agree to the following:

1. Assumption of Risk: I am aware that walking without adult supervision involves potential hazards, including but not limited to traffic, weather, uneven terrain, and the actions of other individuals. I voluntarily assume all such risks on behalf of my child.

2. Waiver of Liability: I release and forever discharge AMI, its officers, directors, employees, volunteers, contractors, representatives, and agents from any and all claims, demands, causes of action, damages, or liabilities arising out of or related to my child's independent travel to or from AMI activities.

3. Indemnification: I agree to indemnify and hold harmless AMI and its representatives from any claims or expenses, including attorney's fees, resulting from my child's participation in this arrangement.

4. Medical Consent: In the event of an emergency occurring during the time my child is traveling, I authorize appropriate emergency medical treatment to be sought on my child's behalf.

Activity Description: Transportation via Uber, Lyft, taxi, or other licensed rideshare/for-hire vehicle services to or from AMI classes, rehearsals, concerts, special events, and/or field trips.

By signing this form, I authorize AMI staff to arrange for my child to be placed in a rideshare vehicle or taxi for transportation as described above. I acknowledge that these services are operated by independent companies over which AMI has no control or oversight.

I understand and agree to the following:

Assumption of Risk: I recognize that using rideshare or taxi transportation involves certain inherent risks, including but not limited to vehicular accidents, delays, driver conduct, and other unforeseen incidents. I accept all such risks on behalf of my child.

Waiver of Liability: I release and discharge AMI, its officers, directors, employees, volunteers, contractors, representatives, and agents from any claims or liabilities of any kind that arise out of my child’s use of such transportation, whether caused by negligence or otherwise.

Indemnification: I agree to indemnify and hold harmless AMI and its representatives from any legal action, costs, or damages associated with my child’s participation in this arrangement.

Responsibility for Provider Conduct: I understand that AMI is not responsible for the actions, omissions, or service quality of any transportation provider.

I understand that AMI is a third-party organization providing extracurricular activities that may take place on the property of the School Board of Miami-Dade County, Florida. These activities will be entirely controlled, staffed, supervised, and insured by AMI, not the School Board.

I acknowledge and agree that:

- The School Board does not manage or enforce AMI’s safety procedures.
- AMI may have its own health and safety protocols that are subject to change based on circumstances.
- It is my responsibility to ensure my child adheres to all applicable federal, state, local, and AMI health/safety guidelines.

I also agree to:

- Conduct a daily temperature and wellness check for my child before program attendance.
- Visually inspect my child for symptoms of illness prior to arrival.
- Promptly pick up or arrange pickup if my child exhibits symptoms during an activity.

Waiver & Release:
In consideration of my child’s participation in AMI activities, I waive and release the School Board, its employees, and agents from any and all claims or liabilities arising from my child’s participation, including injury, illness, or property damage, whether caused by negligence or otherwise.

By signing below, I confirm that I have reviewed and understand the American Music Initiative (“AMI”) program rules, policies, and expectations, and that I will discuss these with my child to ensure their understanding and compliance. I agree to support the program’s mission and to follow the guidelines described in this registration packet. Initial each statement below to indicate agreement:

Acknowledgment

I have read and understand all of the above agreements and will ensure my child follows them.

If the parent/guardian cannot be reached, please contact:

Medical Treatment Authorization:

I authorize AMI staff to obtain medical care for my child in the event of accident, illness, or other emergency, including transportation to a medical facility if

I, _________________________, authorize the AMI Director, Acting Director, or designated teacher to take any necessary steps to secure medical treatment for my child in an emergency situation. Unless immediate action is required, the following sequence will be followed:

Contact the parent(s) or guardian(s).
Contact the child’s physician.
Contact the emergency person listed by the parent(s).

If those efforts are unsuccessful:
a) Another physician will be called.
b) An ambulance (911) will be called.
c) The child will be taken to the emergency room at ___________________, accompanied by a staff member.

I understand that in order for AMI to assume responsibility for my child, I must sign them in at arrival and sign them out at departure.

AMI is committed to using constructive, age-appropriate disciplinary methods to support positive behavior and maintain a safe, respectful learning environment. Disciplinary actions will be used to help students reflect on and improve their behavior.

The following strategies may be used:

Verbal correction and guidance to change behavior.
Redirecting the child from the problem situation.
Ensuring that active play is not denied as a consequence of misbehavior.
Contacting parents if behavior does not improve after redirection.

The following actions are prohibited:

Severe discipline, humiliation, or any form of frightening behavior.
Discipline associated with food, rest, or toileting.
Spanking or any other form of physical punishment.

 

I acknowledge that I have received a copy of AMI’s Discipline Policy.

In certain circumstances, AMI may determine that it is necessary to terminate a student’s enrollment in the program. Such decisions will be based on the best interests of the child, other students, and staff. AMI will make reasonable efforts to resolve issues before expulsion, such as transferring a child to another group, redirecting behavior, separating students in conflict, or other interventions.

Immediate causes for expulsion include:

The child poses a serious risk of harm to self or others.
Parents threaten physical harm or intimidation toward staff.
Parents engage in verbal abuse toward staff in front of children.

Parental actions that may lead to expulsion include:

Failure to pay program fees or repeated late payments.
Failure to complete required forms.
Chronic lateness in pick-up or early drop-off.
Verbal abuse toward staff.

Child behaviors that may lead to expulsion include:

Failure to adjust after a reasonable trial period.
Uncontrollable tantrums or frequent angry outbursts.
Ongoing physical or verbal abuse toward staff or other students.
Excessive biting.

This list is not exhaustive. AMI reserves the right to terminate enrollment at its discretion. When possible, prior notice will be given to the parent/guardian.

 

I acknowledge that I have received a copy of AMI’s Expulsion Policy.

I have read, understood, and agreed to follow all AMI policies and procedures outlined in this registration packet, including but not limited to the Discipline Policy, Expulsion Policy, Attendance Policy, Performance Agreement, and other program rules. I understand that continued participation in the AMI program depends on compliance with these policies and with the standards of behavior expected from students and families.

I also acknowledge that:

- AMI is not responsible for my child before the official program start time or after the scheduled pick-up time.

- Repeated late pick-ups may result in dismissal from the program.

- Program schedules may change, and advance notice will be given when possible.

- All instruments, music, and materials provided by AMI remain AMI property and must be returned in good condition upon request.