2019 AMP @ MoPOP Application
Your application will not be received until you select "Submit" on the last page and see the confirmation message.
Although the required questions are indicated by a red asterisk, we ask that you answer every applicable question.

AMP @ MoPOP will run August 19th - 23, 2019. The age range at this program is between 14-19 years old. All activities and workshops are geared towards participants of this age range with some music background/experience. AMPers are not separated into age groups. If you feel your camper is more suited with a younger age group or beginning level of music experience, please consider signing up for our Summer Camp, which groups participants together by age and does not have any instrument skills prerequisite.

I read the "Rain City Rock Camp Advanced Music Program at MoPOP* Information" document on the application page of the website. *
*MoPOP formerly named EMP
CANCELLATION POLICY
Cancellations more than 30 days prior to camp will be issued a full refund, minus the $50 deposit. Cancellations within 30 days of AMP will not be issued a refund. You can also read our cancellation policy on our website.
PARTICIPANT SECTION
AMPer First Name *
Your answer
AMPer Last Name *
Your answer
Gender Pronoun
Your answer
AMPer Date of Birth *
Your answer
AMPer Email
Please make sure this is an appropriate email to receive notifications from Rain City Rock Camp on
Your answer
School Currently Attending
Your answer
Grade for 2019/2020 School Year
Your answer
What name or nickname would you like on AMP materials (name badge)?
Your answer
What instrument would you like to play at AMP? Please note: Proficiency on your instrument is required *
How many years of experience do you have on your instrument of choice? *
Your answer
Which instrument would be your next choice to play? Please note: Proficiency is required. *
How many years of experience do you have on that instrument? *
Your answer
If you play guitar or bass, do you play left or right handed?
EXPRESS YOURSELF: AMPERS COMPLETE THIS SECTION!
Help our staff get to know you better and tailor our programs so that you can get the most our of your experience!
Tell us about your musical experience. Have you played in a band before or do you play alone? *
Your answer
Do you play other instruments or participate in other artistic activities? *
Your answer
Who are some of your favorite bands, musicians or styles of music? *
Your answer
EXPRESS YOURSELF SUBMISSION PIECE: Tell us about you! As a part of your application, we will be asking you to submit a creative piece based on this year's theme, "Rock It Like We Talk It." *
If you are sending a piece by mail or email please write that in the space provided.
Your answer
I understand that if I did not answer the Express Yourself questions in this application, I must email or mail in my Express Yourself Piece (to programsupport@raincityrockcamp.org OR mail it to 117 E Louisa St #445, Seattle, WA 98102)
What is a personal goal you would like to work on or achieve through your participation in AMP? *
Your answer
How do you feel you work in a collaborative setting? Particularly in creating music/songwriting? *
Your answer
Are you looking to be in a band that continues to play after AMP?
Your answer
PARENT/GUARDIAN SECTION
AMPers range in age from 14 to 19 years old. Bands will reflect that range of ages and will not be separated according to the age of the participants. Please initial here to show that you understand this.
Your answer
Parent/Guardian First Name *
Your answer
Parent/Guardian Last Name *
Your answer
Parent/Guardian Email *
Your answer
Phone
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
What is the best way to contact you with routine information or questions? Our primary method of communication is email. Please be sure to add: programsupport@raincityrockcamp.org to your contacts to avoid SPAM filters. *
Are you an MoPOP member?
Please enter ALL email addresses that would like to receive the program information for your AMPer.
Your answer
First Emergency Contact's Name *
Your answer
Relation to AMPer *
Your answer
First Emergency Best Contact # (During AMP hours) *
Please note if this is a mobile, home or work phone # (m), (h) or (w)
Your answer
First Emergency 2nd Best Contact # (During AMP hours) *
Please note if this is a mobile, home or work phone # (m), (h) or (w)
Your answer
First Emergency Contact Email
Your answer
Second Emergency Contact's Name *
Your answer
Relation to AMPer *
Your answer
Second Emergency Best Contact # (During AMP hours) *
Please note if this is a mobile, home or work phone # (m), (h) or (w)
Your answer
Second Emergency Contact Email
Your answer
Does the AMPer have any medical conditions or allergies? *
A certain level of independence in managing their health needs is required for this program due to offsite lunches, smaller group dynamic, advanced material and freedom to use the restroom (two floors down) without supervision.
If you checked "YES" please list all known conditions so that we may accommodate your AMPer's needs. All information will be kept confidential and shared only with staff as necessary to provide proper care. *
If you checked "NO" please just enter N/A
Your answer
Is the AMPer on any medication to treat these conditions? If so, please list. Please note: We can not administer any medication at AMP.
Your answer
Does the AMPer have any behavioral or emotional issues? Please list all known conditions so that we may accommodate your AMPer's needs. All information will be kept confidential and shared only with staff as necessary to provide proper care.
A certain level of independence is required for this program due to offsite lunches, smaller group dynamic, advanced material and freedom to use the restroom (two floors down) without supervision.
Your answer
Is the AMPer on any medication or routine to manage these conditions? If so, please list.
Your answer
Please use this space to write any additional information that you would like us to know regarding your request for assistance.
Your answer
SLIDING SCALE TUITION
PLEASE READ!
A sliding scale is a tool that can provide equitable access to skill-building and life-long learning opportunities, regardless of financial resources. This method of payment requires active participation and personal reflection on what makes sense for your family’s financial situation, and how you would like to support learning in the Rain City Rock Camp community. The sliding scale is one way of acknowledging differences in wealth, income, costs, and privilege and actively address the economic disparities in our communities and society. Rain City Rock Camp is moving towards this model as a way to say ‘no’ to the ways things are and ‘yes’ to the ways we believe things can be, while providing an excellent rock camp experience for all.

Our scale is $425-$25. At $425, our organization still subsidizes many costs involved with operating this program. If you would like to donate beyond this, you will be contributing to keeping camp accessible AND that donation is tax deductible!

Tuition Pledge *
Note: Anything over $425 is a tax deductible donation!
Your answer
Please provide more information about your answer above. *
This will help us to better understand your situation. All information is confidential.
Your answer
DEMOGRAPHICS SURVEY
Creating a group of AMPers that reflects the diversity of Seattle communities is a priority. In addition, we are occasionally required to report on the demographics of our program in aggregate anonymously. Providing the following information will help us meet our goals. Thank you so much for your time & information.
Estimated Household Income
Your answer
How many people live in your household? Please list the number of adults and the number of children.
Your answer
Please check any and all that apply to your AMPer, or write their preferred identity.
Please check any and all gender identities that apply to your AMPer
Do your AMPer identify as a member of the LGBTQIAP+ community?
How did you hear about us? (Both for the first time and more recently?)
Your answer
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