Rebel Song Academy Sign-up Form

The Rebel Song Academy is at the heart of our programming. Our flagship 12-week music camp takes an innovative approach to exploring young artists’ full potential through creativity, mentorship opportunities, and fostering their inherent sense of exploration and achievement. Students work directly with industry-professional mentors to write, record, publish, and perform an original song. Our 2023 sessions begin on February 1 and conclude at our Spread Hope Concert on May 10!
  • This will be used exclusively to coordinate class schedules, potential field trips and performance opportunities and will not be shared with anyone outside our immediate team.
  • This will be used exclusively to coordinate class schedules, potential field trips and performance opportunities and will not be shared with anyone outside our immediate team.
    *No experience is necessary!
    *Personal info about race/gender/ethnicity are for grant reporting purposes only and will not be shared.
    *Personal info about race/gender/ethnicity are for grant reporting purposes only and will not be shared
  • Parent/Guardian Information
  • Preferred Contact Method (check all that apply)
  • Demographic Information
  • *Personal household information is for grant reporting purposes only and will not be shared.
  • I confirm the truthfulness of the information provided in this form. I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to Art As Mentorship's Terms of Acceptance.
  • I hereby authorize Art as Mentorship and those acting pursuant to its authority to: (1) Record my or my child's image, likeness, and/or voice on a photographic, video, audio, digital, electronic, or any other medium; (2) Use, reproduce, modify, exhibit and/or distribute any such recording, in whole or in part, in any manner or medium now known or hereafter developed (including without limitation, print publications, email, internet, social media, television) for any purpose that Art as Mentorship may deem appropriate, including without limitation promotional or advertising efforts; and (3) Use my name and biographical material in connection with any such recordings or uses. I hereby waive the right to inspect or approve any such recordings and uses . I understand that Art as Mentorship will be the owner of all such recordings and uses. I hereby release and hold harmless Art as Mentorship from liability for any violation of any personal or proprietary right I may have in connection with all such recordings and uses. I have read and fully understand the terms of this consent and release.