Music Theory & History
2026 Summer Program

• Week 1: July 27–31, 2026
• Week 2: August 3–7, 2026

Westside Music Conservatory
12424 Wilshire Blvd Ste 100
Los Angeles, CA 90025

https://westsidemusicconservatory.com/location-directions-parking/

Please e-mail us at info@westsidemusicconservatory.com
or call us at (424) 581-6400 with any questions. THANK YOU!

STUDENT INFORMATION
Please complete a separate form for each student. THANK YOU!

• This program is intended for Students ages 5–18, from Preschool–Grade 12.
• All Students, including those in Preschool and Kindergaren must be reading both English and music notation fluently.

PARENT / LEGAL GUARDIAN INFORMATION

MUSIC THEORY BACKGROUND

TEACHER INFORMATION

CONSENT WAIVERS

Media Waiver

By checking YES above, you acknowledge that you have read and agree to this Term and Condition. By checking YES above and submitting this online form, you acknowledge that you are the participant or parent/legal guardian of the child participant (“Minor”).

I hereby grant my consent, as the participant or paren/legal guardian of the Minor, to Westside Music Conservatory (WMC) to photograph, electronically record, transfer, or film the Minor for distribution in all media at any time, all public performances and appearances in or associated with Music Theory & History • 2025 Summer Program at WMC without any compensation or remuneration.

I also grant to WMC the right to use any such recorded performances, interviews, quotations or photographs of me or the Minor; and the right to use my or the Minor’s name (with permission), voice, image, and likeness in connection with a WMC Event, including but not limited to: publication in books, magazines, pamphlets, advertising, and newspapers; and on television, radio, internet, and social media channels, without any compensation or remuneration.

Consent & Release Agreement

By checking YES above, you acknowledge that you have read and agree to this Term and Condition. By checking YES above and submitting this online form, you acknowledge that you are the participant or parent/legal guardian of the child participant (“Minor”).

I hereby unconditionally release and discharge the Westside Music Conservatory (WMC), their agencies, departments, directors, officers, employees, volunteers, agents, hosts, or collaborating partners, and all other persons and entities involved with Music Theory & History • 2025 Summer Program at WMC from any and all claims, demands, liabilities, damages, costs, and all other expenses that may arise in connection with my or the Minor’s participation in Music Theory & History • 2025 Summer Program at WMC.

I understand that Music Theory & History • 2025 Summer Program at WMC may have a physical element to it. I agree and understand that by signing this Waiver, I am or the Minor is physically fit enough to participate as a volunteer or participant in Music Theory & History • 2025 Summer Program at WMC. I hereby certify that I am or the Minor is in good physical condition and that I am or the Minor is able to participate in Music Theory & History • 2025 Summer Program at WMC without harm to the Minor or others. I agree to voluntarily assume all risks, known or unknown, of injuries, however caused to me or the Minor, even if caused in whole or in part by the action, inaction or negligence of the host or collaborating partners, sponsor, individual and groups involved in Music Theory & History • 2025 Summer Program at WMC, and to hold hosts or collaborating partners, sponsor, individual and groups involved in Music Theory & History • 2025 Summer Program at the Westside Music Conservatory (WMC) free and harmless from any liability or damages for any injuries that I or the Minor may sustain.

Children's Online Privacy Protection Act (COPPA)
Parental Permission Form

By checking YES above, you acknowledge that you have read and agree to this Term and Condition. By checking YES above and submitting this online form, you acknowledge that you are the parent/legal guardian of the child participant (“Minor”).

The Minor’s information is only used in connection with Music Theory & History • 2025 Summer Program at WMC and is limited to the information requested below. It is our practice to only obtain information regarding children under the age of 13 from the child’s parent or guardian and not from the child directly. The Minor’s parent or legal guardian must consent for the collection, use or disclosure of the information requested below. WMC will not share identifiable information of a child with any third party. WMC will only send our promotional communications or newsletters to the parent or the legal guardian who provided the child’s information to us, and WMC will not link, sell, trade, or otherwise transfer to outside parties’ personally identifiable information for any child under the age of 13. If the parent or guardian does not give their consent within a reasonable time, WMC will delete the parent or guardian’s online contact information from our records.

At any time you can review, change or delete your child's personal information, or revoke your parental consent by sending us an e-mail at info@westsidemusicconservatory.com. To protect your privacy and security, we may require you to speak with a representative or take additional steps or provide additional information to verify your identity before we provide any information, make corrections, or disable your child’s registration.

I have had the opportunity to review the WMC Privacy Policy at https://westsidemusicconservatory.com/privacy-policy-terms-conditions/ and authorize my Minor to fully participate in Music Theory & History • 2025 Summer Program at WMC. I understand that I, the legal guardian of the Minor indicated below, will provide the Minor’s necessary information in order to participate in Music Theory & History • 2025 Summer Program at WMC.

I consent to this practice. I understand that I may withdraw my permission granted herein, as set forth in WMC Privacy Policy. I also understand that it is important to provide accurate information in this consent form in case WMC needs to contact me for any reason.

Please have your payment information ready.

• All Music Theory & History • 2026 Summer Program Tuition Fees must be paid online.
• Westside Music Conservatory (WMC) is a division of Pagoda Artworks, Inc. PayPal and credit card payments are made to Pagoda Artworks, Inc.
• After submitting the application form and paying the registration fees online, you will receive a Submission Confirmation at the Parent / Guardian e-mail address(es) you entered above.
• REFUND Policy
  
  • 75% of tutition fees paid will be refunded if cancellation is 28 days before the 1st day of 1st class
  • 50% of tuition fees paid will be refunded if cancellation is 21 days before the 1st day of 1st class
  • 25% of tuition fees paid will be refunded if cancellantion is 14 days before the 1st day of 1st class
  • NO REFUNDS if cancellation is less than 14 days before the 1st day of 1st class

If you select Single Full Day, you will be able to choose the specific day(s).

If you select Single Half Day, you will be able to choose the specific day(s) and morning (9am–12pm) or afternoon (12pm–3pm).