MODE MUSIC AND PERFORMING ARTS WINTER 2022 STUDIO CLASSES

Mode Music and Performing Arts
3801 Delridge Way SW
Seattle WA 98106
http://www.modemusicandperformingarts.org
We've missed you! Join us this season for a fresh schedule of in-studio classes that will engage students with creative, interactive curriculum in a variety of arts disciplines. We will be following all current state and federal guidelines and safety recommendations regarding COVID-19 to keep everyone safe and healthy all season long. If you have any questions, please don't hesitate to contact us! 

STUDENT INFORMATION

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CONTACT INFO (ADULT PRIMARY CONTACT)

PRIMARY ADULT Relationship to Student: *
 
SECONDARY ADULT Relationship to Student:
 

CLASS SELECTION

When you select a class, you are signing up for a total of 8 weekly sessions. Classes run from Monday, January 24 through Sunday, March 27. There are NO CLASSES during Mid-Winter Break (2/21-2/27).
Monday
Tuesday
Wednesday
Thursday
Friday
Sunday

PAYMENT

*If you are paying what you can, please select 100% scholarship and then enter the amount you are able to pay.*
Current Total:
$0.00

DEMOGRAPHIC INFORMATION

Any and all demographic information is optional and any answers will be confidential. Demographic information received will be used by MMPA to receive funding to keep the cost of our programs affordable to all students. Please complete this section to the best of your ability & comfort level.

COVID-19 SAFETY PROTOCOL

I, the undersigned, agree to help protect the health and safety of all MMPA students and staff by adhering to the following protocol:

- Present proof of vaccination for the attending student prior to the start of the first class.

OR

- Present proof of a negative COVID-19 antigen test WEEKLY prior to start of class if unvaccinated. *
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PHOTO/VIDEO RELEASE

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Mode Music and Performing Arts (“MMPA”) is requesting permission to use images and videos from our programming for the purpose of advertising and for the promotion of our non-profit to charitable foundations so we can continue to provide art classes and music lessons to all children, regardless of income. I hereby allow MMPA to use images of my child in these applications and requests. MMPA will notify me of classes that will be recorded or have screen images captured prior to the class. *
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COMPLETION

I, the undersigned parent/guardian of the registrant, acknowledge the possibility that participation in Mode Music and Performing Arts activities could result in physical injury to the registrant. I hereby release, discharge and agree to hold harmless Mode Music and Performing Arts, its officers, directors, employees, agents and affiliates from any and all claims arising from or related to the registrant’s participation in Mode Music and Performing Arts activities. I certify that I have read, understood, and agree to the above conditions, and that the information provided is complete and accurate to the best of my knowledge.  *
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