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Music That Matters Summer Day Camp 2019 (rev.c)

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

In order for your child to have the best possible experience please complete the following registration form.  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 working to improve your registration experience with additional features (auto-population of info for returning students, additional payment options, mobile templates, etc.).  Please pardon any hiccups as we do so.  If you have any questions regarding registration or this form please contact Plugged In directly.

Plugged In is excited to have you participate in our Music That Matters Summer Day Camp.  Together we can make music that changes the world!

Student Information
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First Name
Last Name
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mm/dd/yyyy
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Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country

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Enter grade number only
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Parent Contact Information
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First Name
Last Name
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First Name
Last Name

If different than parent 1

Emergency Contact Information
If the student's parents are unreachable during an emergency whom should we contact?
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First Name
Last Name
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Provide the most reliable number for this emergency contact
Band Placement Information
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Check all that apply
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Provide first and last name. Separate students with a comma.
Check all that apply

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.

Ex: prefers to be with older students, prefers to be with low-key performers, etc.

Ex: student excels in structured environment, student requires breaks, student is shy, etc.
Scholarship
The Plugged In Scholarship Fund was created to meet the need of those students who are interested in participating in Plugged In, but whose family may not have the financial resources to pay full tuition. Applicants may be asked for additional proof of need such as tax returns, recent pay stubs and/or letter of reference. Examples of demonstrated need: limited income, sudden death or abandonment of the primary provider, single parent households, etc.

Please describe the situation you feel qualifies the student for scholarship funds.
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.

Read Release of Liability / Indemnity / Emergency Treatment Agreement

Read Media Release Agreement

Read Code of Conduct Agreement

Read Band Configuration Policy

Read Attendance Policy

Read Concert Scheduling Policy

Read New Student Meeting Policy (new students only)

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Reminder: Students must be available to perform all three concert days.
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Reminder: Parent or guardian must attend the new student meeting.
Payment

Send your payment to:

Plugged In Band Program

40 Freeman Place.

Needham, MA 02492

 

Checks can be made out to Plugged In Band Program.  Please include the student's full name in the memo section of your check.