• Student Registration Form

  • 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 Date of Birth (MM/DD/YYYY):*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Student Background & Education

  • Type of School:*
  • Does the student receive Free or Reduced Lunch?*
  • Is financial assistance requested for participation?*
  • Is the student part of a military family?*
  • Is the student currently involved with DCF, Our Kids, Family Court, or a Case Management Agency?*
  • Is the student currently involved with DJJ, Diversion Programs, or Civil Citation?*
  • Program Referral & History

  • Student Readiness & Support Needs

  • Can the student participate respectfully in large group settings?*
  • Can the student stay focused during extended instruction?*
  • Does the student have a diagnosed disability or IEP?*
  • Is the student diabetic?*
  • Parent/Guardian Contact Information

  • Primary Guardian

  • Format: (000) 000-0000.
  • Secondary Guardian (optional)

  • Format: (000) 000-0000.
  • MEDIA RELEASE & CONDITION OF ENROLLMENT

  • Throughout the school year, students participating in the American Music Initiative ("AMI") may be photographed, recorded on video, audio recorded, livestreamed, or interviewed while participating in classes, rehearsals, performances, field trips, special events, and other AMI-related activities.
    These photographs, recordings, and interviews may be used by AMI and its partners for educational, promotional, fundraising, reporting, archival, and informational purposes.
    Such uses may include, but are not limited to:
    • Newspapers and media publications
    • Program brochures, flyers, newsletters, and annual reports
    • Grant applications and funder reports
    • Television and radio broadcasts
    • AMI websites and online publications
    • Social media platforms, including Facebook, Instagram, YouTube, TikTok, Linkedin, and similar platforms
    • Marketing, advertising, and public relations materials
    I understand that no compensation will be provided for the use of such photographs, recordings, or interviews.
    I further understand that participation in AMI requires acceptance of this Media Release. Due to the nature of ensemble rehearsals, performances, public events, group photography, videography, and organizational reporting requirements,
  • AMI is unable to accommodate students whose parent or guardian declines media consent.
  • By signing below, I grant permission for AMI and its authorized representatives to photograph, record, and use my child's likeness, image, voice, and statements for the purposes described above without additional notice, approval, compensation, geographic limitation, or expiration date.
  • I understand that execution of this Media Release is a condition of enrollment and participation in the American Music Initiative.
  • Date:*
     - -
    2 digit month, 2 digit day, 4 digit year
  • ATTENDANCE AGREEMENT

  • Student Attendance Commitment

  • The American Music Initiative ("AMI") is a performance-based music education program. Consistent attendance is required for student growth, ensemble development, and participation in performances.
  • Minimum Attendance Requirement

  • Students must attend a minimum of three (3) program days per week and remain in attendance until at least 5:00 PM. Students are expected to participate in all scheduled classes, rehearsals, and activities during their time at AMI.
  • The following will be considered an absence:
    • Failure to attend a scheduled program day.
    • Being picked up before 5:00 PM.
    • Failure of a parent/guardian to sign the student out at dismissal.
    • Leaving the program without authorization.
  • Attendance Expectations

  • By signing below, the student and parent/guardian agree to the following:
    • The student will attend a minimum of three (3) program days each week.
    • The student will remain in attendance until at least 5:00 PM on each day attended.
    • The parent/guardian will notify AMI staff in advance regarding absences whenever possible.
    • The student will arrive on time and prepared for class.
    • The family understands that attendance is a condition of continued participation in the program.
  • Attendance Removal Policy

  • Students who fail to meet the minimum attendance requirement for two (2) consecutive weeks, or who demonstrate a pattern of irregular attendance, may be automatically removed from the program at the discretion of AMI.
  • Concert Mode Attendance Policy

  • The week immediately preceding a concert shall be designated as "Concert Mode."
    During Concert Mode:
    • Students must attend at least four (4) of the five (5) scheduled program days.
    • Students must remain for the entire rehearsal period each day.
    • Early pick-up before dismissal will be counted as an absence.
    • Failure to sign a student out will be counted as an absence.
    Students who do not meet the Concert Mode attendance requirement will be ineligible to perform in the concert, regardless of previous participation in rehearsals.
  • Acknowledgment

    I understand and agree to the attendance requirements outlined above and acknowledge that failure to comply may result in performance restrictions or removal from the program.
  • Date:*
     - -
    2 digit month, 2 digit day, 4 digit year
  • PARENT/GUARDIAN WAIVER FOR MINORS & EMERGENCY 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.
  • Format: (000) 000-0000.
  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • EMERGENCY CONTACT, MEDICAL INFORMATION & AUTHORIZED PICK-UP REGISTRY

  • EMERGENCY CONTACT, MEDICAL INFORMATION & AUTHORIZED PICK-UP REGISTRY*
    Rows
  • Medical Information

  • Format: (000) 000-0000.
  • Medical Treatment Authorization

  • I authorize AMI staff to obtain emergency medical care for my child in the event of an accident, illness, injury, or other emergency when a parent/guardian cannot be immediately reached. This authorization includes transportation to a medical facility and emergency treatment as deemed necessary by medical personnel.
  • Parent/Guardian Acknowledgment

  • I certify that the information provided on this form is accurate and complete. I understand that it is my responsibility to notify AMI immediately of any changes to contact information, emergency contacts, authorized pick-up individuals, insurance information, or medical information.
  • Date:*
     - -
    2 digit month, 2 digit day, 4 digit year
  • PERMISSION TO WALK HOME – ACCIDENT WAIVER & RELEASE OF LIABILITY

  • Activity Description: Walking between my home (or designated location) andAmerican Music Initiative (“AMI”) classes, rehearsals, performances, field trips, and/orspecial events. By signing this form, I grant permission for AMI staff to release my child to walk homewithout 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 thesupervision 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.
  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • PERMISSION TO USE UBER/LYFT/TAXI - ACCIDENT WAIVER & RELEASE OF LIABILITY

  • 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:
  • 1. 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.
  • 2. 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.

     

    3. Indemnification: I agree to indemnify and hold harmless AMI and itsrepresentatives from any legal action, costs, or damages associated with mychild’s participation in this arrangement.

     

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

  • Date:*
     - -
    2 digit month, 2 digit day, 4 digit year
  • OBLIGATIONS OF ACTIVITY PARTICIPANTS - WAIVER, RELEASE & HOLD HARMLESS

  • 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:
    1. Conduct a daily temperature and wellness check for my child before program attendance.
    2. Visually inspect my child for symptoms of illness prior to arrival.
    3. 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 theSchool 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.
  • Date:*
     - -
    2 digit month, 2 digit day, 4 digit year
  • RULES ACKNOWLEDGEMENT & AGREEMENT FORM

  • 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:

  • Rules & Guidelines Acknowledgement

  • I understand AMI’s rules and expectations and will ensure my child is aware of them.

  • Photo & Video Release

  • I authorize AMI to photograph, record, or interview my child during program activities. These materials may be used in printed publications, broadcast media, online platforms, social media channels, or any other medium for program promotion. There is no expiration date or geographic limitation on the use of these materials.
  • School Records Release

  • I grant permission for my child's school to share student records with AMI, including but not limited to educational records, Individualized Education Programs (IEPs), meeting minutes, psychological evaluations, social history reports, and health/medical records, if applicable.
  • Pick-Up Agreement

  • I agree to pick up my child promptly after class each day. I understand AMI is not responsible for my child once class has ended.

  • Walk-Home Agreement (if applicable)

  • I permit my child to walk home after class each day. I understand AMI is notresponsible for my child once they leave the program premises.

  • Uber/Lyft/Taxi Agreement (if applicable)

  • I permit my child to travel via Uber, Lyft, taxi, or similar services after class each day. Iunderstand AMI is not responsible for my child once they leave in suchtransportation.

  • Schedule & Attendance Agreement

  • I will ensure my child attends classes regularly and will notify the Chapter Coordinator/Manager in writing or by email if my child will be absent. I will follow my child's program schedule and encourage home practice.
  • Communication Agreement

  • I will maintain regular communication with the Chapter Coordinator/Manager, check for updates weekly, and review any flyers or materials sent home with my child.
  • Performance Agreement

  • I agree to allow my child to perform at AMI concerts and events within and outside the local chapter, and I will attend these performances to support my child.
  • Volunteer Agreement

  • I will volunteer my time during program hours and/or at performances at least twice during the program year.
  • Instrument Care Agreement

  • I will help my child transport, handle, and care for their instrument properly. I will remind my child of its value and the importance of maintaining it in good condition.

  • Acknowledgment

    I have read and understand all of the above agreements and will ensure my child follows them
  • Date:*
     - -
    2 digit month, 2 digit day, 4 digit year
  • AUTHORIZATION FOR EMERGENCY TREATMENT

  • If those efforts are unsuccessful:
  • a) Another physician will be called.
    b) An ambulance (911) will be called.
  • Date:*
     - -
    2 digit month, 2 digit day, 4 digit year
  • DISCIPLINE POLICY

  • The American Music Initiative ("AMI") is committed to maintaining a safe, respectful, and productive learning environment for all students. Discipline is intended to teach responsibility, reinforce positive behavior, and protect the educational experience of all participants.


    The following strategies may be used to address inappropriate behavior:

    • Verbal correction and guidance.
    • Redirection from the problem situation.
    • Individual conferences with students.
    • Parent/guardian notification.
    • Behavioral contracts or improvement plans.
    • Temporary suspension from activities or performances.
    • Removal from the program when necessary.


    The following disciplinary practices are prohibited:

    • Corporal punishment or physical discipline.
    • Humiliation, ridicule, intimidation, or threatening behavior.
    • Discipline involving food, water, restroom access, or medical needs.
    • Any disciplinary practice prohibited by law.


    Progressive Discipline Process

    AMI reserves the right to skip steps based on the severity of the behavior.


    Step 1: Teacher Intervention

    The Teaching Artist will address the behavior through verbal redirection, coaching, and reminders of program expectations. Multiple verbal warnings may be issued when appropriate.

     Step 2: Site Manager Intervention

    If the behavior continues, the matter will be referred to the Site Manager. The Site Manager will meet with the student, review expectations, and document the concern.


    Step 3: Parent Notification

    If behavioral concerns persist, the Site Manager will contact the parent or guardian and provide a verbal warning regarding the student's conduct. Up to three parent conferences may occur before further disciplinary action is considered.


    Step 4: Administrative Review

    The Site Manager may consult with the President or other AMI leadership regarding significant behavioral concerns and potential next steps.


    Step 5: Probation, Suspension, or Removal

    Students who continue to violate program expectations, or whose behavior disrupts the learning environment, may be placed on behavioral probation, suspended from participation, restricted from performances, or removed from the program.


    Immediate Suspension or Expulsion

    AMI reserves the right to immediately suspend or remove a student for serious misconduct, including but not limited to:

    • Fighting or physical aggression.
    • Bullying, harassment, or threats.
    • Possession of a weapon.
    • Theft or intentional property damage.
    • Repeated defiance of staff instructions.
    • Conduct that endangers the safety of students, staff, or volunteers.
    • Use of alcohol, tobacco, vaping devices, or illegal substances.
    • Any behavior deemed by AMI to pose a significant disruption to the program.

    Final Authority

    The Site Manager shall have final authority regarding all student disciplinary matters, including behavioral warnings, probation, suspension, performance restrictions, and removal from the program.


    The Site Manager may consult with the President or other AMI leadership when deemed appropriate. Such consultation is internal and does not create a right of appeal for students or parents/guardians.


    Disciplinary decisions made by the Site Manager are final and are not subject to appeal.

  • Acknowledgment


    I, {insert name below} acknowledge that I have received, read, and understand AMI's Discipline Policy.

  • Date:*
     - -
    2 digit month, 2 digit day, 4 digit year
  • EXPULSION 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.

  • Date:*
     - -
    2 digit month, 2 digit day, 4 digit year
  • PARENT/GUARDIAN ACKNOWLEDGMENT & ENROLLMENT DISCLAIMER

  • 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.
  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: