Children for Children Public Concert (English Medium) – Signup Form

First Name 
Last Name 
Phone Number 
Alternate Phone Number
E mail 
Parent / Guardian Name 
Home Address
Age Group :  
Talent Category 1 :  
If the selected category is other, please specify 
Description of Performance
Individual or Group Performance ? :  
If Group Performance, Number of Participants 
Attach Video of Performance  (mp4 / wmv / mov/ mp3) 
Talent Category 2 :
If the selected category is other, please specify 
Description of Performance
Individual or Group Performance ? :  
If Group Performance, Number of Participants 
Attach Video of Performance  (mp4 / wmv / mov / mp3) 
Child's Consent Accept  
Parent / Guardian Name   Accept  
Please indicate if your child has any special needs or require special assistance ?
  By completing and signing this Declaration, I give permission to the Alumni Association of the University of Peradeniya – Greater Toronto Area and Suburbs, its Board of Management and Members (hereinafter collectively referred to as “the Association”) to: (i) enrol my child in Children-for-Children Concert (hereinafter referred to as “the Activity”), (ii) arrange guidance for my child to , prepare for the concert(iii) Ensure childs particpation in the auditions, rehearsals and the concert , which may accompany my child’s name and other details pertinent to the Activity. I understand that My child’s participation in this Activity is completely voluntary, and is a personal, family decision. I understand that safety of my child during the Activity is my responsibility. I declare that the Association will not be held responsible for any liability or medical expenses, due to an injury sustained by my child during the Activity. I agree to release, indemnify and save harmless the Association from and against all claims, proceedings and/or actions in respect of any costs, losses, damage or injury arising by reason of my child’s participation in the Activity. I understand that refreshments and/or snacks may be served to my child during the Activities related to the concert, and I will immediately notify the Association if such serving is not required for my child, or if there are reservations or restrictions, including food allergies, in which case no such servings may be made to my child. I ensure that all guidelines, instructions, terms and conditions set by the Association aimed at the success of the Activity will be fully complied with by me and my child. I agree to receive paper and/or electronic communications regarding the Activity, and understand that the Association uses our personal data for the Activity’s purposes. I also understand that the Association may photograph and/or video-record my child during the Activity for the Association’s communication and administrative purposes, for which I hereby give permission to the Association, and will notify the Association immediately if I do not wish to grant or keep such permission. Selection for the event is solely the decision of the AAUP.