Child's Information Full Name: *

Date of Birth *

Age: *

Gender: *MaleFemale

Parent/Guardian Information Full Name: *

Phone Number: *

Email Address: *

Emergency Contact (if different from parent/guardian) Name: *

Phone Number: *

Relationship to Child: *

Art Experience (if any) *BeginnerIntermediateAdvanced

From previous activities your child Preferred Class Type *DrawingPainting (Acrylic/Watercolor)Collage & Mixed MediaClay ModelingCraft & Recycling Art

Medical Information Does your child have any allergies or medical conditions we should be aware of? *YesNo

If yes, please specify: *

Permissions & Agreements *I agree to the general terms and conditions of participation, including the documentation of activities for educational and promotional purposes.I acknowledge that my child will follow the hub’s guidelines for a safe and respectful learning environment.

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