Number of Children Registering:
Parent #1 First Name:
Parent #1 Last Name:
Parent #1 Email:
Parent #1 Phone
Parent #2 First Name:
Parent #2 Last Name:
Parent #2 Email:
Parent #2 Phone:
Home Address:
Address Line 2
City:
State:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
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Armed Forces Americas
Armed Forces Europe, the Middle East, an
Armed Forces Pacific
Alberta
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Nunavut Territory
Ontario
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Zip:
-
Zip Suffix
Emergency Contact #1 Name (other than parents):
Emergency Contact Phone #
Emergency Contact #2 Name (other than parents):
Emergency Contact Phone #
Security code:
This code will be used to verify your identity if you call to add someone to the pick-up list.
“ART-RAGEOUS” SUMMER CAMP 2023
Parent Agreement:
Photo Release:
I authorize Young At Art Museum to take photographs of my child/children and their artwork for marketing purposes. I give permission for these pictures to be used in the museum’s printed materials, including advertisements, brochures, flyers, website, and social media. If you do not wish for your child to be photographed, please ensure your child receives a RED “No Photo” wristband upon sign-in each day. If you do not wish for your child to be photographed, please check “NO” in the box above.
Please check this box as acknowledgment that you have read and understood the above camp policies and agree to adhere to all policies as stated.
If you have a coupon, please enter code here (case-sensitive):
Relation of Registrant to Attendees:
Same Household
Same Company