Media Waiver

Full Name

First NameLast Name

Email Address

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Name of Student

First NameLast Name

In Harmony Music Studio reserves the right to use Student's First Name* Student's Last Name* likeness in a photograph, video, or other digital media in any and all of its publications, including web-based publications, without payment or other consideration. In Harmony Music Studio is authorized to edit, alter, copy, exhibit, publish, or distribute these photos for any lawful purpose, and I waive my right to inspection, approval, or royalties.

By signing below I acknowledge that I have read this release, and I understand its contents.