Italy Tour 2019 Registration Form Italy Tour 2019 Registration Due October 1, 2018 Step 1 of 5 20% If you do not yet have a passport, enter all the information as it will appear on your passport. You may wish to note of this information so that your passport will match this form. Your passport information should match your birth certificate and/or driver's license.First name on passport*Middle name on passportLast name on passport*Registration type* Student Chaperone Parent/Guardian (if space permits) Date of birth*Instrument(s) you will bring with you*Special Requests? Address*CIty*State (2 letters)*Zip code*Phone number*Parent email address*Student email address* Passport numberCountry of issuePassport expiration datePassports need to remain valid for 6 months after travel, or through February 2020. Emergency Contact #1 Full Name*Emergency Contact #1 Relationship*Emergency Contact #1 Phone Number*Emergency Contact #2 Full Name*Emergency Contact #2 Relationship*Emergency Contact #2 Phone Number*Payment of a non-refundable $500 deposit due October 1, 2018* Mailing check (MYS; 4800 SW Macadam Ave #105; Portland, OR 972039; student name on memo line) Paying by credit card + $15 processing fee (link available after submitting form) Liabilities* I waive and agree to release and hold Metropolitan Youth Symphony (MYS) from any claims, damages, injury, harm or liability of any nature related in any way to my/our participation in the MYS 2019 Italy Tour. We acknowledge that such a trip involves risks including, but not limited to, personal injury, disease, damage to possessions and cancellation or change of plans. We agree that our participation is at my own risk. This waiver and release extends to MYS and also to its officers, directors, employees, agents and volunteers. We, the parents or legal guardians of the aforementioned MYS student waive and agree to release and hold Metropolitan Youth Symphony (MYS) from any claims, damages, injury, harm or liability of any nature related in any way to our child’s participation in the MYS 2019 Italy Tour. We acknowledge that such a trip involves risks including, but not limited to, personal injury, disease, damage to possessions and cancellation or change of plans. We agree that our child’s participation is at his/her own risk. This waiver and release extends to MYS and also to its officers, directors, employees, agents and volunteers.
