Program
Fall SessionWinter SessionSpring SessionJunior Summer CampSenior Summer CampHausmusik

Student's name

Date of birth

Student's email

Cell phone

Address

City

Postal code

Parent/Guardian email (for under 18 applicants)

Instrument 1 and level

Instrument 2 and level

List of musical experience: (E.g. festival, appearance, chamber music experience, large ensemble experience etc)

YouTube or Dropbox video link 1 (no accompaniment required)

YouTube or Dropbox video link 2 (no accompaniment required)

Teacher's name

Teacher's email

Availability for coaching & rehearsal (6-week sessions only)

E-transfer email (required for e-transfer payment only)

COVID19 LIABILITY RELEASE WAIVER

I further acknowledge that PCMA (Pacific Chamber Music Academy) can not guarantee that I will not become infected with the Coronavirus/Covid-19. I understand that the risk of becoming exposed to and/or infected by the Coronavirus/COVID-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to, staff, and other PCMA students and their families.

I voluntarily seek services provided by PCMA and acknowledge that I am increasing my risk to exposure to the Coronavirus/COVID-19. I acknowledge that I must comply with all set procedures to reduce the spread while attending my coachings, rehearsals and other PCMA events.

I attest that:
* I am not experiencing any symptom of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell.
* I have not traveled internationally within the last 14 days.
* I have not traveled to a highly impacted area within the United States of America in the last 14 days.
* I do not believe I have been exposed to someone with a suspected and/or confirmed case of the Coronavirus/COVID-19.
* I have not been diagnosed with Coronavirus/Covid-19 and not yet cleared as non contagious by state or local public health authorities.I agree to indemnify, defend, and hold harmless the Pacific Chamber Music Academy from and against any and all costs, expenses, damages, lawsuits, and/or liabilities or claims arising whether directly or indirectly from or related to any and all claims made by or against any of the released party due to injury, loss, or death from or related to COVID-19.
YES-I agree with the waiver.No-I DO NOT agree with the waiver.

PHOTO & VIDEO RELEASE WAIVER

I give permission to Pacific Chamber Music Academy to release photos and videos from my participation solely for marketing purposes.
YES-I agree with the waiver.No-I DO NOT agree with the waiver.