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Grace Note Foundation for Music Education

2024 MOMS Summer Band Camp Registration & Waiver

Please complete the following form for each Camper. If you are registering two, you will return to this page after payment.

Field Trip Waiver

By Submitting this form I give permission for my child to travel to Nantucket Swim and Racquet Club as a part of the MOMS Summer Music Camp on the Thursday of camp.

Address:

Nantucket Swim and Racquet Club

5735 Bridgewater Drive SW

Lilburn, GA 30047

I release Music on Main Street from any and all liability concerning my child’s participation in this trip. 

By submitting this form I also affirm that I am the legal parent/guardian of the child listed on this form. I understand that I am responsible for any medical or dental costs not covered by my insurance. I acknowledge the risk of physical injury to myself or my child associated with participation in any and all activities at Music On Main Street, or wherever they may take place. I accept personal financial responsibility for any bodily or personal injury sustained or associated with any and all activities at or sponsored by Grace Note Foundation and Music On Main Street. Further, I promise to hold harmless Grace Note Foundation, Music On Main Street, and their representatives for injury related to or sustained during all activities at BandCamp at Music On Main Street Summer Music Camp. I understand that I am solely responsible for any and all legal or other fees arising from any legal proceeding that I may pursue against Grace Note Foundation and Music On Main Street or their representatives. Lastly, I understand that my child’s photograph may be used for promotional endeavors including but not limited to: videos, magazines, brochures, fliers, web publications, and media presentations.

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