Extracurricular Staff Agreement Name* First Last Name you would like to appear on our website if different from above. First Last Will you be attending the retreat as a student?* Yes No If no, you MUST enroll as a non-student. Contact Ken Fleming at director@oflahertyretreat.org and he will provide you a code that will waive the $25.00 non-student fee when registering.Social Security Number* If you are concerned about entering your social security number here, enter all zeros and later call or text Ken Fleming at (214) 770-5036. Email* Cell Phone*Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Would you like to donate your pay in support of the retreat?* Yes, count me in. Yes, but I choose to remain anonymous as a donor. No, not this time. If yes, we will list your name as a Retreat Partner on our website and in slides we show at our instructor concerts.I have viewed my profile on the retreat website, and I —* Would like to make changes. Am satisfied with what I see. Haven’t seen it and trust everything is okay. Sorry, I haven’t sent you my bio and/or photo but will do it ASAP. Send changes to director@oflahertyretreat.org very soon.Comments:Regarding instructional aids, audio visual equipment and other items that you will need for enrichment classes or workshops, we will send you a link to an online form prior to the retreat for you to register those needs.Terms of AgreementBetween the Traditional Irish Music Education Society (hereafter referred to as TIMES), and the named individual entered above (hereafter referred to as STAFF) regarding the O’Flaherty Irish Music Retreat (hereafter referred to as RETREAT). STAFF agrees to be engaged as an independent contractor and will prepare and conduct enrichment classes, workshops, performances and/or lead sessions at the RETREAT during the period October 19th-22nd, 2023. TIMES agrees to pay an honorarium fee to STAFF by the closing of the RETREAT on Sunday, Ocotber 22nd for STAFF’S services as previously agreed. Such fee is based on the following pay rates: $75.00 for presenting an enrichment class or workshop, $50.00 for performing at a guest concert or instructor concert, and $50.00 for leading a session. STAFF gives permission to TIMES and its representatives to photograph, videotape and record STAFF’S enrichment classes, workshops, performances and/or sessions for its use in the marketing of RETREAT or for its educational purposes. Unless STAFF objects in writing, such recordings of workshops and performances may also be used for fundraising through CD or video sales and STAFF’S concert(s) may be streamed live to help raise needed funds to defray the cost of the RETREAT. STAFF understands that only performers of instructor concerts may provide merchandise to the RETREAT Store for sale, however, STAFF has permission to sell merchandise at their enrichment classes, workshops or guest concert performances. STAFF is responsible for sales taxes if any. STAFF agrees to defend, indemnify and hold harmless TIMES, its volunteers and managers, its board of directors, and other representatives, from and against any and all actions, costs, claims, losses, expenses or injuries arising out of the acts of STAFF at RETREAT including liability for taxes, insurance and workers compensation. By signing below, I understand and agree to the terms of this agreement as stated above.Presenter's Signature*Date* Month Day Year CAPTCHA Δ
