Education Art Enrichment Form

EDUCATION ART ENRICHMENT FORM

Program Information

Session Start Date:    End Date:    Days/Times:

Payment Plan (select all that apply)

Student Information

Date of Birth:    Student ID:    Grade / Program:

Parent / Guardian Information

Primary Phone:    Secondary Phone:

Emergency & Medical Information

Emergency Contact Phone:    Physician / Clinic:

Materials, Safety & Participation Acknowledgment

I acknowledge that the art enrichment program may use common art materials including paints, adhesives, inks, clay, solvents, and cutting tools under supervision. I accept responsibility for notifying program staff of any sensitivities or restrictions. I understand that instructors will provide supervision and safety instructions, but participation involves inherent risks including minor injuries and exposure to art materials.

Photography and Media Release

Photographs, audio, and video recordings may be taken during program activities for educational, exhibition, and promotional purposes. No compensation will be provided for such use.

Transportation / Off-Site Activities

The program may include supervised travel between campus locations or to off-site exhibition venues. Transportation will be provided by school-approved vehicles or contracted providers.

Liability Release, Indemnification & Medical Authorization

In consideration of participation in the Art Enrichment Program, I, on behalf of the student named above, hereby assume all risks associated with participation. I release, waive, and discharge the program, its governing body, employees, contractors, volunteers, and agents (collectively the "Program Parties") from any and all liability, claims, demands, actions, or causes of action arising out of or related to any loss, damage, injury, or death sustained by the student, whether caused by the negligence of the Program Parties or otherwise, to the fullest extent permitted by law.

I agree to indemnify, defend, and hold harmless the Program Parties from and against any claims, liabilities, losses, costs, and expenses (including reasonable attorneys' fees) arising from my child's participation, except to the extent caused by the Program Parties' gross negligence or willful misconduct.

I authorize program staff to obtain emergency medical treatment for the student if necessary. I agree to be responsible for costs associated with such treatment and will promptly notify the program of any subsequent changes to medical or insurance information.

Policies, Cancellation & Refunds

Enrollment is secured upon receipt of payment according to the selected payment plan. Refunds will be issued only in accordance with the program's written refund policy: session withdrawal prior to the first class may qualify for a partial refund less administrative fees; withdrawals after the first session are not eligible for refund except in documented extraordinary circumstances. The program reserves the right to cancel or reschedule classes; in such cases fees will be refunded or credited unless otherwise required by policy.

Student Experience & Permissions

Acknowledgment and Authorization

By signing below, I certify that the information provided on this form is true and complete to the best of my knowledge. I authorize the Program Parties to use this information for program administration and emergency response. I understand that falsification or omission of required information may result in denial of participation. I further acknowledge that I have read, understand, and agree to the terms, releases, authorizations, and policies contained in this form.

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