Media Consent – Franklin Pond Chamber Music

Student Name

Please enter student's first and last name

Media Consent

I certify that I have read the Media Consent and Release Liability statement and fully understand its terms and conditions as it relates to the above named student ().

Parent/Guardian Signature

This field serves as your electronic signature.

I do consent to the Media Consent and Release Liability statement.

I do NOT consent to the Media Consent and Release Liability statement.

Payment Options

I will pay the application fee online, after clicking "Submit" (via PayPal).

I will pay the application fee via check (U.S. mail).