Media Recording Wavier Consent Form

Image, Video/Audio and Media Recording Wavier Consent Form

At the Academy, we host picture day that is very popular with our parents. Our photographer will visit the school and takes pictures of our lovely students and parents, students and parents will also get to order copies.

We also video, film and photograph recitals and events occasionally.  In our monthly newsletter we also feature students of the month, video and film student performance for Youtube, Internet, our website and other digital media outlets.

If you would like for you or your child to participate in student of the month, picture day, recitals or our newsletter, please sign this Image, Video/Audio and Media waiver form.


I,  hereby authorize Musipire Professional Music Education, Musipire Media Productions, and those acting pursuant to its authority, or with its permission, to interview and/or to have photographs, audio or audiovisual recordings made of the above named minor (“Media Images”).

I understand that these Media Images may be released to the public by the news media or by Musipire Inc. in broadcast, print, or Internet media.  I also understand that the Media Images may be used by Musipire Inc. for advertising and marketing purposes.  These Media Images may be used in whole or part as long as this is in effect and Musipire Inc. has not received notice that this consent has been revoked.  I also understand that I am not required by Musipire Inc. to authorize the above consent, and that authorization is not a condition of receiving music education.

I further understand that the name of the student or minor may be used in connection with these Media Images unless I have specifically restricted such use.

I release Musipire Professional Music Education, Musipire Media Productions, and its affiliated organizations, Regents, officers, agents and employees from any and all liability connected with capture or use of these Media Images.

I waive all rights, interest or claims in connection with any exhibition or release of these Media Images.  I understand that this consent is voluntary and can be revoked at any time.  I give my consent in the interest of public information, and for furtherance of education, or for other lawful purposes.

I acknowledge that I have legal authority to sign this form on behalf of myself, the student/minor(s) named above.



除此之外,伟乐和 也经常性地不定期举办音乐会及各项活动并进行内部数位音频,视频和活动演出等录制。同一时间,我们也于每个月发布内部电子邮件和电子报纸,并采访和拍摄介绍伟乐当月的优秀学生。 以上所有内容,伟乐团队将视适合程度,不定期在YouTube,互联网,及我们的官方网和其他数字媒体渠道上会有分批和精采的展示。



本人, 已授权伟乐专业音乐教育中心, 及伟乐媒体制作团队,和其相关子公司和合作伙伴,根据本人授权对本人及本人的受监护人进行采访、拍摄、录音、录影。制作照片、音频或视听记录(以下简称“媒体图像”)。







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