Participant Registration Form

In consideration for my child being permitted to participate in the activities included in this program, I, on behalf of my child, and as the custodial parent and/or as the legally authorized guardian, do hereby for my child, myself, my family, heirs, personal representatives, and assigns, agree to, and hereby do, release, waive, discharge, hold harmless and indemnify, and forever defend Palmetto Concert Band, the University of South Carolina, the State of South Carolina, their respective Boards of Directors or Trustees, individually and collectively, and their respective officers, employees, servants, agents, representatives, directors, members, students, volunteers, and anyone acting on behalf of Palmetto Concert Band or the University of South Carolina, from any and all liability, losses, claims, actions, suits, procedures, demands, rights, and causes of action of whatever nature, in law and equity, for any and all known or unknown, foreseen or unforeseen, bodily or personal injuries, death and permanent injury, illnesses, damage to property, or other losses, and any consequences thereof, including expenses, costs, and attorney’s fees, as may be sustained by my child or me, or any person or entity acting on my or my child’s behalf, arising out of, or in any way associated with, my child’s participation in the program.

I, as the custodial parent and/or legally authorized guardian of my child, hereby grant permission to Palmetto Concert Band and the University of South Carolina (USC), including their respective agents, employees, representatives, assignees, and successors, without expectation of compensation or other consideration, to:

Record my child’s likeness, image, appearance, and voice through photography, video, audio recordings, film, or any other medium;

Use my child’s name, likeness, image, voice, and biographical information in connection with such recordings and materials; and

Exhibit, reproduce, publish, distribute, and otherwise use such recordings and materials, in whole or in part, without restriction or limitation, for educational, informational, promotional, publicity, or advertising purposes, including websites, social media, printed publications, and other communications, as deemed appropriate by Palmetto Concert Band, the University of South Carolina, or those acting under their respective authority.

I understand that these recordings and materials may be used publicly and that I will not receive compensation for their creation, publication, or use.

• I give permission to the medical personnel selected by the program director to provide routine health care: administer medications when necessary, order x-rays, routine tests, treatment, release any records necessary for insurance purposes, obtain a copy of my child’s health record and/or speak with health care providers regarding my child’s health status, and provide or arrange for necessary related transportation for me/or my child.
• If I cannot be reached, I give permission to the physician/health care provider selected by the program director to secure and administer treatment, including hospitalization, for my child.
• I give the program staff the permission, in case of accident or injury, to administer standard first aid/or to arrange for transportation to a medical facility.

I have reviewed the program activities organized by Palmetto Concert Band and declare that my child is physically and otherwise capable of participating in them.

I agree to immediately notify Palmetto Concert Band program staff, University of South Carolina (USC) staff, and/or host site administrators of any situation, condition, or circumstance of which I am or become aware that may present a potential hazard or risk to my child or others.

I understand and agree to the following expectations and responsibilities for my child and myself:

My child and I will abide by all rules, guidelines, regulations, codes of conduct, and other requirements established by Palmetto Concert Band, the University of South Carolina, and the applicable host site or facility.

I understand that my child may be asked to leave or be removed from the program if either my child or I fail to comply with the established rules, regulations, codes of conduct, or host site requirements.

Palmetto Concert Band’s designated program director, instructors, and authorized program staff shall have the authority to make decisions regarding my child’s continued participation in the program. If my child’s conduct or other circumstances warrant removal, dismissal, disciplinary action, or other intervention, such action may include requiring my child to return home at my sole expense, with or without prior notice to me, and may result in the forfeiture of program fees, deposits, or other payments.

I agree to complete and submit all required forms, documentation, and program-related fees by the established deadlines. I further agree to maintain appropriate medical and health insurance coverage for my child throughout their participation in the program.

I acknowledge that I am solely responsible for any expenses incurred on behalf of myself or my child in connection with participation in the program, including, but not limited to, medical treatment, health care expenses, emergency transportation, and other related costs.

I acknowledge that I have reviewed, understand, and agree to the terms and conditions outlined in this document and any applicable program requirements established by Palmetto Concert Band, the University of South Carolina (USC), and the host site. I understand that my child’s participation in the program organized by Palmetto Concert Band is voluntary, and I hereby give my consent for my child to participate.

I certify that I am at least 18 years of age and am the custodial parent or legally authorized guardian of the participating child, with the legal authority to provide consent on their behalf.

I certify that all information provided in connection with my child’s registration and participation in this program, including personal, medical, and emergency contact information, is true, accurate, and complete to the best of my knowledge. I agree to promptly notify Palmetto Concert Band of any material changes to this information prior to or during my child’s participation.