Creating Music with Coding Spring 2023 (cc)

CREATING MUSIC WITH CODING
This is a virtual program on zoom

Wednesdays 4:00-5:30 PM

February 27, 2023 - June 18, 2023

Plugged In is an inclusive music program that empowers musicians to make positive change in the world with their music. Plugged In is open to any student regardless of their skill level, race, gender, sexuality, disability, religion, economic status, etc.

Completing our online registration form will take about 5 minutes. Please be aware, there is no option to save an incomplete registration form and return to it at a later time.

Questions marked with a red asterisk are required and must be answered before submitting your registration.

Plugged In is excited to have you participate in our spring Creating Music with Coding class. Together we can make music that changes the world!

Other *

How did you hear about Plugged In?

Has the student participated in Plugged In programming before? *

Yes

Student Information

Student Name *

First Name

Last Name

Pronouns *

Please indicate the students preferred pronouns.

Student Birthdate *

mm/dd/yyyy

Student Address *

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Student Email

Verify Email

Student Home Phone *

Student Mobile Phone

School Name *

Current Grade *

Enter grade number only

Does the student have a family member participating in Plugged In's Spring 2023 music technology classes? *

Yes

Parent Contact Information

Parent 1 Name (primary contact) *

First Name

Last Name

Parent 1 Primary Phone *

Is parent 1 primary phone a cell or home phone? *

Cell

Home

Parent 1 Email *

Verify Email *

Parent 1 Employer

Parent 2 Name

First Name

Last Name

Parent 2 Primary Phone

If different than parent 1

Is parent 2 primary phone a cell or home phone?

Cell

Home

Parent 2 Email

Verify Email

Parent 2 Employer

Emergency Contact Information

Whom should we contact in case of an emergency? If registering for the youth program, please provide an alternate contact to the student's parents.

Emergency Contact Name *

First Name

Last Name

Emergency Contact Primary Phone *

Provide the most reliable number for this emergency contact

Additional Information

Other *

Student's Primary Device

What digital audio production tools (software/hardware) has the student used in the past?

Other *

What style of music does the student prefer most?

In order for the student to have the best possible experience at Plugged In, we strongly encourage you to share information regarding medical conditions, disabilities, behavioral and emotional concerns, allergies, etc.

PLEASE CHECK ALL THAT APPLY - (Information regarding a student may be shared with the Plugged In Directors and their teacher, and will otherwise remain confidential.) .

Autism Spectrum Disorder (ASD)

Attention Deficit Disorder / Hyperactivity Disorder (ADD/ADHD)

Depression

Anxiety / Social Anxiety

Allergies

Physical Limitation

Other

Other *

Please identify and describe the student's condition.

Would you like to be contacted by the Plugged In Inclusion Committee?

Plugged In is a fully inclusive program. The Plugged In Inclusion Committee works with students/families that may need additional supports to ensure their best possible experience.

Yes

Please share any information that would be important for the band teacher to know in working with the student.

Ex: student excels in structured environment, student requires breaks, student is shy, etc.

Showcase

Plugged In holds a benefit concert at the end of every program session. For our online programs, this event is a livestream showcase of student projects. In addition to presenting their projects and performances, the benefit concerts and showcases also give students a unique opportunity to give back to the community. Each benefit concert and showcase raises funds and awareness for a charity chosen by the session's students. The concerts and showcases show students they can make positive change in the lives of others by doing something they love, like creating music.

The Fall Session Benefit Concert and Showcase will be June 16-18, 2023.

Showcase Scheduling

We do not accept showcase scheduling requests. All students must be able to perform/present when scheduled.

Would the student like to get information about joining our Youth Board?

Yes

Are you (the parent or adult student) interested in volunteering at Plugged In?

Plugged In is always looking for skilled adult volunteers for various roles. If you like to volunteer for Plugged In please select "yes" and our Volunteer Outreach Coordinator will contact you.

Yes

Policy

To participate in Plugged In you must read, understand, and agree to the following policies. If you have questions regarding any of the following policies please contact Plugged In directly.

The student and/or guardian have read and agree to the Media Release Agreement *

Yes

The student and/or guardian have read and agree to the Code of Conduct Agreement. *

Yes

The student and/or guardian have read and agree to the Attendance Policy. *

Yes

FOR NEW STUDENTS ONLY - The student and/or guardian agree to participate in a "new student meeting" prior to the start of the session. *

If the student is under 18 years old a parent or guardian must also attend the new student meeting.

Yes

Payment

$770 - Spring 2023 Creating Music with Coding

Payment *

$720 - Spring 2023 Creating Music with Coding - family discount

Creating Music with Coding Spring 2023 (cc)

Student Information

Parent Contact Information

Emergency Contact Information

Additional Information

Read Release of Liability / Indemnity / Emergency Treatment Agreement

Read Media Release Agreement

Read Code of Conduct Agreement

Read Attendance Policy