Rock to the Future - MusicWithMe Registration Form
Join us as we launch our first intergenerational music program! MusicWithMe provides a monthly drums/percussion workshop to Rock to the Future students and community members, allowing youth to learn music with a trusted adult in their life. Register as a pair (one adult +18 and one student grade 2 - 12). Workshops are free, snacks are provided, and no experience is required! Space is limited so click below to sign up and someone will be in touch with a registration form.

Where: NOMO North - 925 N Broad St, Philadelphia, PA 19123

Thank you for registering for our Rock to the Future MusicWithMe monthly Workshops! 

After you complete this registration form, one of our team members will follow up with you to confirm your participation!

You must register as a pair (one adult and one student). 

Unfortunately, we cannot accommodate one guardian with multiple students. 
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Adult Participant First Name and Last Name *
Adult Participant Date of Birth *
 (must be +18 years old)
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Adult Participant Email *
Adult Participant Phone *
Student First Name and Last Name *
Student Date of Birth *
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Relationship of adult to student 
(ex. parent, aunt/uncle, grandparent, older sibling, friend, etc)
Student Gender *
Student Race  *
Student Ethnicity
 *
Student Grade Level 
 *
Home Address *
City *
State *
Zip Code *
What MusicWithMe Workshop would you like to register for? *
Please only choose one workshop per date according to the student age range. You can register for multiple dates if you wish to participate multiple times. 
Required
Notes
This form is not a guarantee of participation! Our team member will contact you within 2 weeks to confirm your registration. Thank you!
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