Acknowledgement of Review of Workshop Summary *

By checking this box, I hereby acknowledge that I have read and reviewed the application introduction/ workshop summary. I have gone over these details with my guardian.

Name: *

First Name

Last Name

Date of Birth: *

MM

DD

YYYY

Phone Number: *

(###)

###

####

Home Address: *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent/Guardian Name: *

First Name

Last Name

Parent/Guardian Work Phone Number:

(###)

###

####

Parent/Guardian Cell Phone Number: *

(###)

###

####

Parent/Guardian Home Address:

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent/Guardian address is the same.

How would you describe your music experience? *

This is my first time writing and performing songs.

I am a mid-level single/rapper/musician.

I am very advanced at rapping, singing, musicianship and performing.

Is the participant currently being treated for an injury or sickness, or taking any medications? *

No

Yes

Free/Reduced lunch at school?

Check this box if the participant qualifies for free or reduced lunches at school.

How did you hear about The Bridge?

After-School Program

School

Website

Social Media

Word of Mouth

Flyer

Other

Media Release: Guardian Agreement *

*Have your guardian review this statement and agree by checking the box.

By checking this box, I, The Guardian, understand that photos, video and audio recordings of my youth can be used on The Bridge Music Project and City of Olympia’s website, social media pages, and for other promotional purposes.

The Bridge Music Project Liability Waiver: *

In consideration for The Bridge Music Project accepting my and/or my child’s entry into this camp/program, I personally, and on behalf of my child, assume all risks and hazards incidental to the conduct of the activity. I do further release, absolve and waive any right to bring a claim, action suit, or other proceeding against The Bridge Music Project, the City of Olympia; the Olympia Parks, Arts and Recreation Department; Olympia School District No. 111; the organizers and sponsors of the program; or instructors of the program for damages due to any injuries suffered as a result of participation in the program.

I hereby agree to the terms of this Waiver of Liability. This waiver is in force for the entire duration of the class and whenever I am on property used by The Bridge Music Project, both interior and exterior.