MEPAA Afternoon Kidz Rock Camp!
Kidz Rock Camp will focus on learning songs with various instruments including guitar, bass guitar, ukulele, keyboards, drums/percussion and vocals in a group setting with open jam time at the end of each day and a group performance time in a low-pressure, safe environment that encourages musical exploration!

All 5 days are just $85.
Drop off is 3:00pm and pick up is 6:00pm
Offered multiple weeks, no two weeks will be the same, so sign up for all!

Email address *
Parent/Guardian Name *
Your answer
Camper Name *
Your answer
Will your camper be joining us from an Upstart Crow Camp? *
Camp will be at the Upstart Crow Studio Building: 855 West 1st Ave, Eugene OR 97402. When you enter through the front door, you want to go right and head up the stairs to the upper level. Drop off time is 3:00pm, pick up is by 6:00pm. Signing up for the week of: *
Date of Birth *
MM
/
DD
/
YYYY
Best Day Time Phone Number *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Phone Number *
Your answer
Any allergies or medical conditions we should be aware of? *
Your answer
Musical Experience? Not required, we're just curious.. *
Your answer
Anything else we should know about your camper? Just to let you know, we are up a flight of stairs. *
Your answer
Music Education & Performing Artists Association (MEPAA) will admit students of any race, color, gender, national and ethnic origin to the rights, privileges, programs, and activities generally accorded or made available to students at the Music Center. It does not discriminate on the basis of race, color, gender, national and ethnic origin in administration of its educational policies, admissions policies, scholarship programs, and other school-administered programs.Access to restrooms that correspond to gender identity is available. A person shall not be required to use a restroom that is incongruent with their gender identity. Single-stall bathrooms are available on site. *
MEPAA events may be filmed or have photographers on site. By signing this form you are authorizing us to capture the event and to use any resulting media for organizational marketing purposes. *
Tuition for summer camps is due at the time of registration and will hold your spot in camp. Tuition is not prorated for any missed days or time. Tuition is non-refundable unless the camp is cancelled by MEPAA. You will receive a confirmation email on the completion of this form with our PayPal link for payment. *
In consideration of the right to participate in this activity, I release any and all claims for damages and losses suffered by me or my minor child as a result of said participation against Music Education & Performing Artists Association (MEPAA), and agents thereof. I further understand there are risks inherent in this activity and agree to assume those risks on my behalf or on the behalf of my minor child and to hold harmless Music Education & Performing Artists Association (MEPAA) and its agents. This release is to be signed upon registration (online or in writing). *
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service