Program Registration

The WJAI Fall - Winter Jazz Mentor Workshop

Please fill out and submit the form below to register for the WJAI Fall/Winter Saturday program. The program begins on the 1st Saturday of October and ends on the 1st Saturday of March. We do not operate on major Holiday weekends. * Use the tab to move from one field to the next.

Student Name *

First

Last

Email *

Last 4 of SSN# *

Please provide the student's last 4 digits of their social security number.

Date of Birth *

Address Line 1

City

Emergency School SSN#

State

Zipcode

Phone

Current School *

Grade *

If between grades, list the grade the student will be in at the start of the next school year.

Instrument

Parent or Guardian *

First

Last

Name *

First

Last

Parent/Guardian Email Address *

Parent/Guardian Phone Number

Emergency Contact Name and Relationship

Emergency Email

Emergency Phone Number

Permission & Agreement *

I have read and agree to the Washington Jazz Arts Institute Summer Jazz Mentor Project participation requirements.

As the parent or legal guardian, I give permission for my child to participate in the Washington Jazz Arts Institute Summer Jazz Mentor Project. I understand that participation is subject to the program's policies, procedures, and expectations. I authorize The Washington Jazz Arts Institute to photograph and record my child for educational and promotional purposes. I understand that pre-scheduled concerts are mandatory, and excessive absences may result in termination from the program. *We do not meet during national holiday weekends.