Congratulations!

We look forward to welcoming you to the HIMA USA

Chamber Music Workshop

August 13 -18, 2023

Registration

Confirm your participation in the HIMA USA 2023 Chamber Music Workshop by filling out the below form and paying your deposit of 50% of the tuition (you may also choose to pay the tuition in full at this time). Each individual must complete a separate registration form. The Chamber Music Workshop dates are August 13 - 18, 2023. The program begins on August 13 at 8:30 am. If you are traveling from out of town, it is recommended that you arrive in the Lakeside area on August 12 in order to be ready to start the workshop on the morning of August 13. Final festival activities (final concerts) will take place in the afternoon and evening of Friday, August 18.

All instructional activities (rehearsals, coachings, master classes) will take place at the Danbury School located adjacent to the Lakeside Chautauqua main gates. Concerts will take place within the Lakeside Chautauqua campus. Artist-faculty concerts and string quartet concerts will take place on some evenings during the festival and all festival participants are strongly encouraged to attend these concerts.

Tuition: $800 per person, includes shared housing, daily breakfast and lunch provided on site and an admissions pass to Lakeside Chautauqua for the HIMA USA participant for each day of the workshop. Housing will be located in the private, lakefront community of Lakeside Chautauqua.

In addition to filling out the below registration form, please email your quartet biography and one or two high-resolution quartet photos to info@himafestivalusa.org.

Registration Form

Name

First Name

Last Name

Chamber Ensemble Name

Instrument

Violin

Viola

Cello

Phone

(###)

###

####

Mailing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Individual Bio

Please share your individual bio below. Please include schools attended and instructors.

List any allergies here

List any dietary restrictions here

Is there anything else you wish for us to know? If so, use this space to share this information.

Emergency Contact Name

First Name

Last Name

Emergency Contact Phone

(###)

###

####

Physician Name

Please list: 1) Name 2) Phone number 3) Address

Medical Insurance

Please list 1) Insurance Carrier/Plan Name 2) Policy Number 3) Subscriber Name 4) Subscriber's Relationship to you

RELEASE: By writing my name in full below, I understand and authorize the statement below.

In case of emergency, accident, or serious illness to myself and I am unable to communicate, my name below authorizes HIMA USA to exercise their own judgment in contacting the physician indicated on this form and to follow his/her/their instructions. If this physician is unavailable, HIMA USA may make whatever arrangements are necessary to transport me to a hospital emergency room.

WAIVERS AND INFORMED CONSENT: By writing my name in full below, I understand and authorize the statement below.

By agreeing to this form, I hereby assume all risks and hazards incidental to the conduct of the activities at Harpa International Music Academy USA (hereafter referred to as HIMA USA). I am fit for the program(s) in which I have enrolled. I hereby release and shall defend, indemnify and hold harmless HIMA USA, their board of directors, representatives, agents, employees, volunteers, members, sponsors, promoters, and affiliates (collectively “releasees”) from every claim and any liability that I may allege against releasees (including reasonable legal fees and costs) as a direct or indirect result of harm to me because of my participation in any HIMA USA programs, whether caused by the negligence of releasees or others to the maximum extent permitted by law. I promise not to sue releasees on my behalf regarding any claim arising from or related to my participation in any HIMA USA program(s). I acknowledge that, by agreeing to this document, I am releasing releasees from liability. This sign up and release form are a contract with legal and binding consequences and it applies to all activities in which I engage during the summer academy at HIMA USA, regardless of whether such activity is a part of a formal program. I have read this release carefully before agreeing. I understand what this release means and what I am agreeing to by accepting. I understand that no insurance coverage for participants in these activities is provided by HIMA USA. By registering for this program, I understand and agree that if a portion of the program is unable to be completed due to unforeseen circumstances under responsibility of HIMA USA, I will receive a prorated refund for the uncompleted portion of the program if I have paid tuition. I also understand that no refunds or proration will be given for any other reason.

Media Permission: By writing my name in full below, I understand and authorize the statement below.

I consent to the use by HIMA USA, without further consideration, of photographs, videos, audio recordings and other media representing myself, for advertising or other purposes.