Find Your Pride Registration

Find Your Pride Registration

Find Your Pride: LGBTQIA+ Arts and Culture Summit hosted by ComMUSICation
Date & Time: Thursday, October 15th from 9:00am - 5:00pm

Location: Creative Arts Secondary School - 65 E Kellogg Blvd, St Paul, MN 55101

Find Your Pride is an all day Summit for LGBTQIA+ youth and allies hosted by ComMUSICation. Youth will have the opportunity to create, express themselves, and perform.

Sessions will include the intersection of identity and voice, self-expression and activism through performance, mixed media, and mental wellness.

Open to youth ages 13-22.

Register by October 5 for a special swag bag and for transportation!
Youth Participant Information
Participant Name

First NameLast Name
Preferred Pronouns
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Participant Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Participant Email
example@example.com
Home Address (Street Address, City, and Zip Code)

Street Address (required)

Street Address Line 2 (optional)

City (required)State (required)

Postal / Zip Code (required)
- ComMUSICation participates in the Sprockets out-of-school time network, which aims to improve the quality and availability of after-school and summer programs for youth and their families in Saint Paul.
  
  Information about you/your child’s participation in our programs will be used to help assess the quality and effectiveness of out of school time programs. Information about you/your child will be kept confidential and you/your child will never be identified in any evaluation or research reports. You have the right to review the Data Privacy Notice. If you do not want you/your child’s data to be included in evaluation or research related to Sprockets, please tell our staff and sign the non-consent form they provide. This will NOT affect you/your child’s participation in the program.
- What school do you attend?
- What grade are you in?
- Race/Ethnicity
- Gender
  
  Other
- Do you qualify for free or reduced lunch?
- T Shirt Size - In many of our programs, we provide ComMUSICation t-shirts to participants. Please indicate your preferred t-shirt size below. "Youth" sizes are typical for elementary-aged youth.
- Parent/Guardian Information
- Parent/Guardian Name
  
  First NameLast Name
- Parent/Guardian Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Parent/Guardian Email
  You may receive monthly updates, but can opt out at any time
- Emergency Contact Information
  
  Please provide information on who we should contact in case of an emergency.
- Emergency Contact Full Name
  Please provide first and last name.
- Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Relationship to Participant
  ex: mom, dad, grandparent, sibling, cousin, aunt/uncle, family friend etc.
- Please provide any other information that you think would be helpful to us in an emergency.
- Medical
- Do you have any allergies or dietary restrictions/preferences?
- Please list your allergies and/or dietary needs below :
  ex: gluten free, vegetarian, tree nut allergy, allergic to bee stings, latex allergy, penicillin allergy etc.
- Please list any other medical conditions that we should be aware of (as well as any specialized medications).
- There will be a mental health professional onsite during Find Your Pride. Please let us know if there are any specific topics or resources you’d be interested in learning more about during the day so we can be prepared to support you better!
  Your information is kept confidential and is only shared with the mental health specialist.
- Transportation
  
  In many circumstances, ComMUSICation is able to provide transportation to and from the program site. If you wish to request transportation via the ComMUSICation van, please fill out the information below, and we will communicate with our Transportation Partner to see if you can be added to the route.
- I would like to request transportation to and from Find Your Pride (please read the options carefully)
- Preferred PICKUP Site
  ex: home, school (please include name), recreational center, etc.
- PICKUP Site Address
  
  Street Address (required)
  
  Street Address Line 2 (optional)
  
  City (required)State / Province (required)
  
  Postal / Zip Code (required)
- Preferred DROPOFF site
- DROPOFF Site Address
  
  Street Address (required)
  
  Street Address Line 2 (optional)
  
  City (required)State / Province (required)
  
  Postal / Zip Code (required)
- Transportation Release
  
  ComMUSICation will be providing transportation through a contract with the nonprofit NewTrax. Newtrax is a 501(c)3 transportation nonprofit that provides transportation services for adults with disabilities, employer/corporate groups, faith communities, and health clinics. All NewTrax drivers pass a rigorous background check, receive “defensive driving” training, and are CPR certified. ComMUSICation may share family contact information with NewTrax in order to facilitate pickups/dropoffs or in case of emergency.
- As a condition of transportation by ComMUSICation’s partner NewTrax, I understand and agree that: I will not hold ComMUSICation responsible for any harm or loss that may occur to my child before, during, or as a result of this transportation or release, including but not limited to, accidents, injuries, or theft; I will be responsible for, and will save ComMUSICation harmless from any claims by others for any loss, cost, or expense arising out of harm or loss that may occur to my child as a result of the transportation or release; and in an emergency, I hereby give permission to licensed medical providers selected by ComMUSICation to hospitalize, secure proper treatment, anesthesia, or surgery for my child at any expense.
- Signature for Transportation Release
- Photo/Video Release
  
  There may be times when ComMUSICation (CMC) staff, the media, or other organizations, with the approval of the Executive Director, may take photographs of students, audio/videotape students, record concerts, or interview students for CMC-related promotional or fundraising materials in a way that may individually identify a specific student (including their first name).
- I grant to ComMUSICation, its staff and agents, permission to use my/my child’s photographs and/or videotaped images and words for the purposes mentioned above. I understand and agree that CMC may use these photos and/or videotaped images in subsequent years unless I revoke this authorization by notifying the Executive Director in writing. Furthermore, I hereby consent that such photographs, films, recordings, projects, and tapes are the property of CMC, and they shall have the right to distribute, duplicate, reproduce, and make other uses of them as they wish, free and clear of any claim whatsoever on my part. I understand that if I would like to opt out this, I must speak directly to the Music & Program Director or another Teaching Artist before the start of the activity.
- Signature for Photo/Video Release
- Should be Empty:

Find Your Pride Registration

Youth Participant Information

Parent/Guardian Information

Emergency Contact Information

Medical

Transportation

Transportation Release

Photo/Video Release