Parents' Night Out at Mechanical Eye - Registration for March 2017
You know what's better than a babysitter? A MOVING MAKING ADVENTURE!

Parents' Night Out at Mechanical Eye Microcinema
March 17, 2017 6-9pm (Flexible drop-off: 5:30-6 and pick-up: 9-9:30)
Youth ages 4-11
Tuition: $25/individual student, $40/two siblings, $55/three siblings

Nondiscrimination Policy
Mechanical Eye Microcinema values diversity and does not discriminate on the basis of age, race, economic status, gender expression, size, physical ability, developmental ability, learning style, nationality, religion, citizenship status, or sexual orientation in the administration of its educational programs, admissions policies, sponsorships, and other camp related policies and programs. *
Required
Basic Information
Student Name *
Your answer
What is your student's current age?
Your answer
Parent/Guardian Name
Your answer
Parent/Guardian Email
Your answer
Parent/Guardian Phone
Your answer
Emergency Contact Information
Emergency Contact Person *
Your answer
Emergency Contact Phone Number *
Your answer
The following people may pick up my child:
Your answer
We will provide pizza and popcorn. If your child has special dietary needs, please pack them dinner/snack. *
Please let us know if your child has any allergies, dietary restrictions, or medical concerns we need to be aware of.
Your answer
Tuition
Mechanical Eye Microcinema is a volunteer-operated, non-profit organization powered by fundraisers and donations from our community. These contributions help us acquire the resources we need to enrich our classes and provide students with supplies, equipment, a place to film, and a hands-on, participatory and supportive filmmaking experience!

Tuition for Parents' Night Out is $25/student. (Sibling discount: two siblings - $40 total, three siblings - $55 total). If you are in need of financial sponsorship for your student, or if you'd like to sponsor another student, please email us at mechanicaleyemicrocinema@gmail.com.

Tuition is due when you drop your child off. Payments can be made via cash or check to Mechanical Eye Microcinema. Please put the class & student name on your checks!

Media Release
Mechanical Eye Microcinema & class instructors will post digital versions of all work made in classes online. Any photos, recorded (video or audio) and written materials created for and/or during Mechanical Eye Microcinema classes may be used for promotional purposes by Mechanical Eye Microcinema & class instructors in the future.
Student, please type your name to acknowledge that you agree to our media release statement/policy. *
Your answer
Parents please type your name to acknowledge that you agree to our media release statement/policy. *
Your answer
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