MMPA SUMMER 2021 ONLINE AND IN-PERSON CAMP REGISTRATION

Mode Music and Performing Arts
3801 Delridge Way SW
Seattle WA 98106
http://www.modemusicandperformingarts.org
We are excited to offer a full roster of music, theatre, art, and dance camps for all ages! For Summer 2021, MMPA is offering a full schedule of virtual Zoom camps in the AM and in-person camps in the park in the PM that will engage students in self-expression, creativity, and community through the arts.
 
Online campers will receive a link to enroll in a Google Classroom where you will have access to all necessary links for live video calls and weekly recorded lessons. The classroom will also allow you to interact directly with your instructor and enjoy additional materials and resources that are relevant to the class. 
 
Campers in the park will meet with their teacher at Hiawatha Playfield in front of the Community Center to check in.

STUDENT INFORMATION

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CONTACT INFO (ADULT PRIMARY CONTACT)

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

MMPA SUMMER CAMP SELECTION

AM VIRTUAL CAMP SELECTION

Choose one of more weeks of 9am-12pm online camps @ $225
 
*10% off your total order multiple class signup. Enter coupon code MULTIPLECAMP for the discount in the payment section below.*
Select the class(es) you wish to enroll in below.

PM IN THE PARK CAMP SELECTION

Choose one of more weeks of 1pm-4pm online camps @ $300
 
*10% off your total order for multiple camp signup. Enter coupon code MULTIPLECAMP for the discount in the payment section below.*
Select the class(es) you wish to enroll in below.

PAYMENT

*If you require a scholarship for classes, please indicate partial or full scholarship below. You will be contacted by MMPA after your registration is processed with the amount we are able to offer*
 
Discounts for multiple classes will be applied after checkout. Please contact 206-659-0463 or email billing@modemusicandperformingarts.org with any questions.
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.

STANDARD PHOTO/VIDEO RELEASE FOR MINORS

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. *

COMPLETION

Completion of this form will automatically subscribe you to our Mode Music Studios newsletter. This is a monthly publication that includes information on upcoming events, private lesson deals, and upcoming MMPA enrichment sessions. You can opt out at any time.
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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