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Includes Permission Form, Code of Conduct and Discipline Form, and Extended Campus Form. There are three separate forms—please read and sign each, then click the submit button when finished with all three.

  • PERMISSION FORM

  • This form is to be used in consideration for allowing a student to participate in the Summer@Eastman Programs. THIS DOCUMENT AFFECTS YOUR LEGAL RIGHTS. PLEASE READ IT CAREFULLY BEFORE SIGNING.

    In consideration for allowing the above-named student (“Student”) to participate in the Eastman School of Music (“School”) Summer@Eastman Programs (defined as: The Artistic Flutist: Bonita Boyd International Flute Masterclass, Eastman Cello Institute, Eastman Experience: Summer Classical Studies, Eastman Experience: Summer Jazz Studies, Eastman French Horn Institute, Eastman Percussion Festival, Eastman Saxophone Project (ESP) Institute, Eastman Summer Saxophone Institute, Eastman Summer Trombone Institute, Eastman Summer Trumpet Institute, High School Wind Ensemble, Summer Organ Academy, The Unbroken Circle: Native American Song and Dance Workshop, each of the foregoing a “Program”), I, as Student’s parent/guardian, understand and agree that:

  • PERMISSION

    Student has my permission to attend all parts of the Program.

  • RISK ACKNOWLEDGEMENT

    Participating in the Program involves a risk of injury or harm. All such risks are being assumed knowingly and voluntarily by me and Student, including but not limited to those associated with travel to and from the program. These programs involve residing in campus housing, eating at dining facilities, using athletic facilities, receiving classroom and/or private music instruction, and going on field trips, and so carry the usual risks of such activities including, but not limited to, physical injury and/or illness from falls, insect or animal bites, athletic contact, transportation accidents, food contamination and chemical exposure.

  • HEALTH STATUS; INSURANCE

    Student is physically fit and in a condition that will allow him or her to participate fully and safely in the Program. Student has medical insurance that covers him or her for accidents and illnesses while participating in the Program. I understand the School has not made, nor will make, any investigation into Student’s physical fitness or ability to participate in the Program and the School relies on my statement of Student’s physical condition. I assume full responsibility for payment of medical expenses not covered by insurance incurred as a result of Student’s participation in the Program.

  • FIELD TRIP RELEASE

    I understand that participation in the Program may include field trips and other activities away from the campus site. Field trips may include some of the following destinations: Letchworth State Park, Seabreeze amusement park, off-campus concerts, museums, etc. I give permission for my student to attend these functions and to be transported by program-approved transportation. I hereby release the Eastman School of Music, the University of Rochester, and the officers, trustees, employees, agents, and volunteers of the aforementioned organizations from all actions, claims, or demands for damages resulting from my child’s participation in the activities, and from liability and damages, injuries, or losses which might be sustained by my child, except those caused by the direct and sole negligence of the aforementioned organizations. NOTE: Field trips are included in residential students’ housing fees. Commuter students may choose to attend field trips but will be responsible for their own transportation, food, and any admission charges.

  • EMOTIONAL ADJUSTMENT

    Occasionally, students deal with emotionally challenging issues. Summer@Eastman staff members are trained to assist students in adjusting to a new environment, a rigorous class schedule, and the challenge of being away from home for a substantial amount of time. The Summer@Eastman Programs at the Eastman School of Music do not have the facilities or staff to assist students experiencing serious emotional distress; any student who exhibits behavior that poses a threat to the health or safety of him or herself or others may be required to leave the Program immediately.

  • LIABILITY RELEASE

    I hereby release and indemnify the University of Rochester and the School, their employees, officers, Trustees, and volunteers (“Releasees”) from any and all liabilities, losses, claims, demands, costs, and expenses of any nature whatsoever arising out of any loss, personal injury (including death), or property damage, that I or Student may sustain, arising from Student’s participation in the Program, and due to any cause whatsoever, including the Releasees’ own negligence, unless due directly to the gross negligence or willful misconduct of the Releasees. It is my express intent that this Agreement shall bind the members of my and Student’s family, estate, heirs, administrators, assigns, or personal representatives. I understand that Student’s participation in the Program is entirely voluntary, and I sign this document freely and voluntarily, having read and understood it.

    I agree to abide by the School’s regulations. I understand that all fees must be paid prior to the beginning of instruction and that no deduction or refunds will be made for late arrival, early departure or expulsion.

  • SIGNATURES

    Your signatures below indicate that you have read and understand the information outlined above.

  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • CODE OF CONDUCT AND DISCIPLINE

  • The Summer@Eastman Programs (each a “Program”) at the Eastman School of Music (hereafter “School”) create a living and learning experience designed to challenge high-achieving high school students. Participating in this unique experience, however, carries some responsibilities. As members of the learning community, program participants (hereafter “Students”) are expected to meet the challenges of the rigorous academic program and participate with enthusiasm in community activities. It is also expected that personal integrity, respect for the rights of others, and a positive attitude will enable Students to maintain the highest standards.

    This Code of Conduct is intended to promote group cohesiveness and foster an environment conducive to the achievement of the Program’s goals. If a Student is unsure what this Code or any policy means, he or she has the obligation to ask.

    Compliance with this Code of Conduct is required of all Students. Failure to comply may, at the discretion of the School, result in dismissal from the program. In the event of a significant violation, the Student’s parent or guardian will be contacted.

  • RESPECT OF OTHERS

    Program participants shall be respectful of the Eastman School of Music community, which includes people with diverse backgrounds and beliefs. Conduct that is disrespectful or demeaning to others, including but not limited to verbal or physical harassment, will not be tolerated.

  • PROHIBITED ACTIVITIES

    The following actions are prohibited during any part of the Program (including field trips and transportation as well as on the School campus):

    • Possession, use, distribution, or being in the presence of alcohol or illegal drugs
    • Misuse of prescription drugs
    • Use of tobacco products
    • Possession or use of weapons (including--but not limited to--firearms, fireworks or other explosive materials, knives, or other items intended or commonly used to inflict harm) -- any weapon found will be confiscated.
    • Disorderly Conduct (including but not limited to):
      • Fighting, including hitting or pushing another person, either as an aggressor or in response to actions of another.
      • Behavior that is otherwise reckless, disruptive, or dangerous to person or property.
      • Verbal or physical harassment of others including, but not limited to, bullying, cyberbullying and playing pranks or practical jokes, including via electronics.
      • Misuse, damage to, or theft of School property. Students will be liable for damage to Eastman School of Music property. The use of tape and the driving of nails, screws, or tacks into walls or furniture is prohibited. No furniture may be moved out of the assigned quarters, and no equipment (other than occasional pieces such as bookcases, table, lamp) may be added without permission. Damages found or additional cleaning that needs to occur upon check out time will be documented and billed to the Student’s account. Common charges are as follows: additional cleaning range from $35.00 to $125.00; replacement of a room key $125.00; damages to furniture or property range from $50 for scratches to furniture to the cost to replace.
      • Tampering with or misusing fire or emergency equipment.
      • Use of a camera, cell phone or other video or audio recording device in spaces where privacy is expected, such as restrooms, showers, locker rooms and bedrooms being used by others.
      • Failure to comply with the reasonable request of an Eastman School of Music official.
      • Interaction of a sexual nature or sexually suggestive manner with any other person (applies to any student under the age of 18).
      • Traveling outside the designated campus area boundary or leaving campus without permission (see: Extended Campus form) or supervision.
      • Allowing non-residential visitors into students’ rooms. Housing is limited to registered students only.
  • RESPONSIBILITY FOR DAMAGES

    Students and parents may be held financially responsible for any damage to or loss of School property caused by Students.

  • CELL PHONE USE

    While Students may carry their cell phones, the phones should remain off during class time and should not be visible, unless otherwise instructed by Summer@Eastman faculty. We reserve the right to take a student’s phone if the student is asked to put it away and refuses. The cell phone will be returned to the student at the end of class. Repeated violations may result in dismissal from the Program.

  • ATTENDANCE POLICY

    Coming to class is a very important part of the Program, and it will be difficult to understand the academic material without attending every class. Classes should only be missed in the case of an emergency or illness. If this is the case, please contact the instructor and Residential Life as soon as possible via email or phone.

  • PLAGIARISM POLICY

    As members of an academic community, students assume certain responsibilities. One of these responsibilities is to engage in honest academic work. Academic dishonesty may include plagiarism (misrepresenting someone else’s work as one’s own), copying the academic work of a fellow student, or collaborating with another student unless permitted by the instructor. These are serious violations of the trust upon which an academic community depends. Academic dishonesty may lead to dismissal from the Program.

  • POLICY FOR CONTACTING PARENTS

    Summer@Eastman and Residential Life Staff may contact parents using the phone numbers provided in the application and for the following instances:

    • Any illness or injury
    • Alcohol or Other Drug use
    • Multiple unexcused absences
    • Multiple violations of any policy
    • *Student Dismissal from the program

    *If a student is dismissed from the program, a parent/guardian is required to make travel arrangements within 48 hours of receiving notice. Failure to do so may result in additional fees for area lodging and supervision of the program participant. Summer@Eastman, Residential Life, and the Eastman School of Music are not responsible for arranging additional housing, meals, or supervision of participants who have been dismissed from the program.

  • POLICY VIOLATIONS

    Alcohol and Other Drugs; Damage to facilities; Weapons; Harassment; Violence:

    May result in dismissal from the program and no refund of housing costs

    Quiet Hours:

    Warning; $25 fine for each offense thereafter

    Hall Sports/Roughhousing:

    Warning; $25 fine for each offense thereafter

    Visitation:

    Parental Notification; $50 fine; dismissal from the program

    Unexcused Absence:

    Warning; Parental Notification; $50 fine; dismissal from program

    Curfew:

    Warning; Parental Notification; $50 fine; dismissal from program

    Leaving Eastman Campus without permission:

    Parental Notification; $50 fine; dismissal from the program

  • STUDENT PLEDGE

    I agree to attend all scheduled classes/coachings/lessons, participate in all events, and to abide by the rules and regulations given in this form and in supplemental materials, if applicable. I have read and understand this Code of Conduct. I understand that if I do not comply with the Code of Conduct I may be dismissed from the Program. I understand that all fees must be paid prior to the beginning of instruction and that no deduction or refunds will be made for late arrival, early departure or expulsion. If dismissed from the Program, I will remain in a designated area until pickup or departure from the Eastman Campus within 48 hours of receiving notice. Failure to do so may result in additional fees for area lodging and supervision.

  • SIGNATURES

    Your signature below indicates that you have read and understand the Code of Conduct outlined above.

  • Date Format: MM slash DD slash YYYY
  • PARENT OR GUARDIAN PLEDGE

    I hereby permit Student to attend the Summer@Eastman Programs and to be governed by Code of Conduct and any other applicable School rules. I have discussed with Student the Code of Conduct and the need to obey all rules, regulations, and instructions of Summer@Eastman Programs personnel. I understand that Student’s failure to obey the above may result in his/her dismissal from the Program. I also understand that all fees must be paid prior to the beginning of instruction and that no deduction or refunds will be made for late arrival, early departure or expulsion. If dismissed from the Program, I understand that Student will remain in a designated area until pickup or departure from the Eastman Campus, which should occur within 48 hours of the phone call made by the Program Director to the Student’s parent or guardian. Failure to do so may result in additional fees for area lodging and supervision.

  • Date Format: MM slash DD slash YYYY
  • EXTENDED CAMPUS FORM

  • STUDENT INFORMATION

    Students under age 18 attending Summer@Eastman programs must remain on the Eastman School of Music campus footprint which is supervised by the School’s security (marked on map in yellow). However, parents or guardians may allow their child to go beyond the campus footprint within the area marked in green lines. This area is not supervised by the School’s security. Students who choose to go in the area bordered in green must be back within the campus footprint (marked in yellow) by 9 pm.

    Extended Campus Map

  • AUTHORIZED TO PICK UP STUDENT:

    Please list names and phone numbers of parents/guardians and any other trusted adults (relatives, family friends) who have permission to pick up the child. If a parent/guardian, relative, or other adult is NOT authorized to pick up the child, please include their name and information in the “not authorized” section, below.

  • First and Last Name:Cell phone with area code 
  • AUTHORIZED BY:
  • Date Format: MM slash DD slash YYYY