Liability Waiver Form

Please, submit this form before

your first lesson.

I agree to release GSK Music, LLC DBA PianissiMore, its directors, employees or assigns from any liability for damages incurred as a result of the use of GSK Music, LLC DBA PianissiMore facilities or participation in the GSK Music, LLC DBA PianissiMore lessons, performances and other activities. I also agree to indemnify GSK Music, LLC DBA PianissiMore, their directors, employees or assigns and hold them harmless from any and all action resulting from the use of GSK Music, LLC DBA PianissiMore facilities or participation in the GSK Music, LLC DBA PianissiMore lessons, performances and other activities. It is understood that any injury or accident that occurs outside of class time in either the building or on the grounds of the GSK Music, LLC DBA PianissiMore will be the full responsibility of the parent or guardian. My child’s (my) photo and/or video may be used for promotional purposes including print and the Internet. My signature below signifies understanding and acceptance of the terms listed above. Name(s) of children attending the GSK Music, LLC DBA PianissiMore lessons, performances and other activities:

Name of student

Your name

Phone

Your Signature

Select a date

I accept terms & conditions

Thanks for submitting!

Liability Waiver Form

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