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.

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I,  hereby authorize Musipire Professional Music Education, Musipire Media Productions, OnlineMusicLesson.com 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be used in whole or part as long as this is in effect and Musipire Inc. has not received notice that this consent has been revoked.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, OnlineMusicLesson.com 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.

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在伟乐音乐中心和 OnlineMusicLesson.com，我们平日举办的摄影日活动在学生和家长中深受欢迎。摄影师将专门为我们中心可爱的学生和尊敬的学生家长们进行专业摄影和拍照等活动。活动之后，摄影团队也将提供学生和家长们选购照片副本等机会。

除此之外，伟乐和 OnlineMusicLesson.com 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。

如果您希望您或者让您的孩子参与本月优秀学生活动、摄影日活动、演奏会或者电子月报报道，请在以下图像、视频、音频和媒体授权同意上签字。

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本人, 已授权伟乐专业音乐教育中心，OnlineMusicLesson.com 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”）。

本人同意这些媒体图像可以由新闻媒体或伟乐教育中心通过广播，印刷或网络媒体向公众发布。伟乐音乐教育中心可能会将媒体图片用作广告和市场宣传目的。伟乐音乐教育中心在没有收到撤销通知前，这些媒体图像将可以被全权使用。此授权不是本人或受监护人在伟乐音乐教育中心接受教育的前提或硬性规定条件。

本人同意，本人及受监护人的姓名可以与这些媒体图像结合使用，除非本人特别限制了此类使用。

本人已免除伟乐专业音乐教育，伟乐媒体制作及其相关姐妹机构和行政人员，管理人员，代理人和雇员对拍摄或使用这些媒体图像相关的任何责任。

此同意是本人自愿的，并可以随时撤消。本人本着有益于公众的利益、为促进音乐教育或其他合法目的而表示同意。

本人具有代表自己（上述学生/受监护人）签署此表格的法律权限。（18岁以下未成年学生必须由父母及监护人代签）