Studio Artist Class Registration

Parent/Guardian Information:


I am a Museum of Art DeLand Member:    YES    NO

Child Information:


Please check Session(s) for which you are registering:*


Session 1 January 11 - February 1 3D Extravaganza
Online Registration for Session 1 is Closed. Please call the Museum for availablity: 386-734-4371
Session 2 February 8 - March 1 Drawing Basics
Online Registration for Session 2 is Closed. Please call the Museum for availablity: 386-734-4371
Session 3 March 29 - April 19 Digital Art
Online Registration for Session 3 is Closed. Please call the Museum for availablity: 386-734-4371

List adults authorized to pick up your child/children
(please include first & last name that matches ID of authorized adult):*


Are there any allergies or medical issues we should be aware of?:*    YES    NO
Please list allergies or medical issues:

Liability Waiver:



In consideration of The Museum of Art, DeLand, Florida, Inc. (hereinafter referred to as "Museum") agreement to permit my child to participate in the Museum's programs, and realizing that participation in the art/class programs will involve physical activities, the nature of which might result in injury to my child, I do hereby hold harmless and release the Museum from any and all liability to the Museum and its employees or agents as a result of such injury.

In the event that my child becomes ill, I authorize the Museum staff to obtain medical attention for my child at a physician's office or hospital. I understand that someone from the Museum's staff will attempt to reach me before medical treatment is given to my child. Furthermore, in the event that such need arises, I authorize the Museum to provide minor medical treatment for my child.

I understand that the Museum has the right to dismiss any student for any serious misbehavior and that I will not be entitled to a refund of tuition.

By signing this form, I acknowledge that I have read and understand the above policy.

This agreement is a legally binding instrument when signed by registrant.

Electronic Signature:*

I understand that checking this box constitutes a legal signature.*


Photo Waiver:



I give permission to The Museum of Art, DeLand, Florida, Inc. (hereinafter referred to as "Museum") for my child to be photographed and/or videotaped while attending art/class and to use photographs, videotapes, film, audiotapes, and the art work and/or writings of my child's participation for promotional purposes in published materials, in other works of art, and on the Museum's website and Internet (World Wide Web). Neither my child nor I will receive compensation for the use of these materials.

By signing this form, I acknowledge that I have read and understand the above policy.

Yes, I give permission for my child/children to be photographed.

No, I do not want my child/children to be photographed.

Electronic Signature:*

I understand that checking this box constitutes a legal signature.*


Summary:


Subtotal:$0
Discount(s):$0
Total:$0

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