Drumline Trial Class Sign-Up

Authorized Pick-Up & Secure PIN (Youth Participants Only)
To ensure the safety of all youth participants, Joy Rhythm Academy uses a Secure Pick-Up PIN system. Only individuals listed below who can provide the correct PIN will be authorized to pick up the participant.
Primary Pick-Up Person Name:
Relationship to Participant:
Secondary Pick-Up Person Name (optional):
Relationship to Participant:
Secure Pick-Up PIN (4 digits):
This PIN should be kept confidential and shared only with approved pick-up individuals.
Pick-Up Policy Acknowledgment
- A valid PIN is required for pick-up
- No exceptions will be made without prior written approval
- Photo ID may be requested
  If a PIN is forgotten, identity verification will be required and may delay dismissal
  By signing below, you acknowledge and agree to the pick-up policies.
Parent/Guardian Name:
Signature
Date:

MonthDayYear
Date

Participation Agreement
Participants agree to:

Treat instructor(s) and peers with respectFollow safety instructionsParticipate in a supportive, positive environment
Participant Signature/ Parent or Guardian Signature*
Date:*

MonthDayYear
Date
Media Release
I give permission for Joy Rhythm Academy to use photos and videos of the participant for educational and promotional purposes, including but not limited to social media, marketing materials, and the program website.*

YesNo
Liability Waiver & Release
Assumption of Risk & Release of Liability
I understand that participation in Joy Rhythm Academy programs involves physical activity, including repetitive arm, hand, and body movements, use of percussion instruments, and group movement. I acknowledge that these activities carry inherent risks, including but not limited to muscle strain, soreness, or minor injury.
I voluntarily assume full responsibility for any risk of injury, illness, or loss that may occur as a result of participation.
By signing below, I acknowledge that I have read, understood, and voluntarily agree to this waiver.
Participant Name:*
Signature of Participant or Parent/Guardian *
Date:

MonthDayYear
Date

Emergency Contact Information
Participant Name:*
Parent/Guardian (if applicable):
Emergency Contact Name:*
Emergency Phone Number:*
Contact Information:
Email: kierra@joyrhythmacademy.com
Website: joyrhythmacademy.com
Thank you for choosing Joy Rhythm Academy. We are excited to drum with you and share the joy of rhythm!

Nothing is needed for class. If you have drumsticks, feel free to bring them.
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