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Members are responsible for paying the full membership fee regardless of registration time or attendance.
MEMBERSHIP BENEFIT

20 % discount on private music classes.

20 % discount on Transforming Life Coaching sessions.

Priority in obtaining tickets for concerts and celebratory events.

Membership Starting Date: Membership Renewal Date:

Membership open enrollment and renewal August 1-16.

SIGNATURE OF THE ATTENDEE: DATE:
Rumi Academy Center: Mailing Address: Tel: (818) 290 – 0965 www.rumiacademy.org
17909 Medley Dr. 21500 Califa St., Unit 167 Fax: (818) 585 – 9050 (©) @alipajooheshgar

Encino, CA 91316 Woodland Hills, CA 91367 [email protected]
Rumi Academy
Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19 & Rumi Academy

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is
extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal. state, and local
governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the
congregation of groups of people.

Rumi Academy by Ali Pajooheshgar has put in place preventative measures to reduce the spread of COVID-19; however, the
Academy cannot guarantee that you will not become infected with COVID-19. Further, attending the Academy group and private
classes, music rehearsals and events could increase your risk of contracting COVID-19.

By signing this agreement, | acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that may be exposed
to or infected by COVID-19 b attending the Academy and that such exposure infection may result in personal injury, illness,
permanent disability, and death. | understand that the risk of becoming exposed to or infected by COVID19 at the Academy may
result from the actions, omissions, and negligence of myself and others, including, but not limited to, Academy employees, other
students, and their families.

| voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself (including, but not
limited to, personal injury, disability, and death), Illness, damage, loss, claim, liability, or expense, of any kind, that | may experience
or incur in connection with my attendance at the Academy or participation in Academy activities and events. On my behalf. | hereby
release, covenant not to sue, discharge, and hold harmless the Rumi Academy by Ali Pajooheshgar, its employees, agents, and
representatives of and from the Claims, including all liabilities cams. Actions, damages, costs, or expenses, of any kind arising out of
or relating thereto. | understand and agree that this release includes any Claims based on the action’s omissions, or negligence of
the Academy, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation
in any Academy services. My signature indicates | DO NOT HOLD Rumi Academy by Ali Pajooheshgar and members of the Academy
are accountable for any accidents or the spread of COVID-19 that may occur as a result of participation in the Academy activities.
The participant is physically qualified to attend the class. | hereby authorize the Academy staff by Ali Pajooheshgar to act for me,
according to their best judgment, in any medical emergency

Audio and video recording consent

| authorize Rumi Academy by Ali Pajooheshgar acting through its agents, employees, or representatives, to take photographs, video
recordings, and/or audio recordings of me, including my name, my image, and my performance, and/or my voice (“Recordings”). |
also grant Rumi Academy an unlimited right to reproduce, use, exhibit, display, perform, broadcast, create derivative works from,
and distribute the Recordings in a manner or media now existing or hereafter developed, in perpetuity, throughout the world. |
agree that Rumi Academy will have final editorial authority over the use of the Recordings, and | waive any right to inspect or
approve of any future use of the Recordings. | acknowledge that | am not expecting to receive compensation for participating in the
Recordings or for any future use of the Recordings. | release and fully discharge Rumi Academy, and its employees, agents, and
representatives, from any claim, damages, or liability arising from related to my participation in the Recordings or Rumi Academy’s
future use of the Recordings.

SIGNATURE OF THE ATTENDEE: DATE:
Rumi Academy Center: Mailing Address: Tel: (818) 290 – 0965 www.rumiacademy.org
17909 Medley Dr. 21500 Califa St., Unit 167 Fax: (818) 585 – 9050 (©) @alipajooheshgar

Encino, CA 91316 Woodland Hills, CA 91367 [email protected]

Silver M / Y
  • New’s (Monthly Emails to members & Upcoming Concerts/ Events? Retreats) P
  • Access to view Persian or English (Audios/ Videos/ Tasnif)P
  • Early Bird Access to Upcoming Concerts & Events P
  • In person or Zoom Class Access P
  • Foundrasing / Gala Events
  • Discount on upcoming Concert & Event Tickets
  • Private Events (New Year/ Rumi BD/ Yalda)
  • Monthly class access in person/ zoom
  • Yearly Rumi Academi Book
  • House Concerts (Private)
Gold M / Y
  • New’s (Monthly Emails to members & Upcoming Concerts/ Events? Retreats) P
  • Access to view Persian or English (Audios/ Videos/ Tasnif)P
  • Early Bird Access to Upcoming Concerts & Events P
  • In person or Zoom Class Access P
  • Foundrasing / Gala Events P
  • Discount on upcoming Concert & Event Tickets P
  • Private Events (New Year/ Rumi BD/ Yalda)P
  • Monthly class access in person/ zoomP
  • Yearly Rumi Academi Book
  • House Concerts (Private)
Platinum Yearly
  • New’s (Monthly Emails to members & Upcoming Concerts/ Events? Retreats) P
  • Access to view Persian or English (Audios/ Videos/ Tasnif)P
  • Early Bird Access to Upcoming Concerts & Events P
  • In person or Zoom Class Access P
  • Foundrasing / Gala Events P
  • Discount on upcoming Concert & Event Tickets P
  • Private Events (New Year/ Rumi BD/ Yalda)P
  • Monthly class access in person/ zoomP
  • Yearly Rumi Academi Book P
  • House Concerts (Private) P
X