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K-Pop Paint Party Student Information Form - October 4th

STUDENT INFORMATION

Student Name

First Name

Last Name

Age

PARENT/GUARDIAN INFORMATION

Parent(s)/Guardian(s)

First Name

Last Name

Phone Number(s)

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

EMERGENCY INFORMATION

Emergency Contact

First Name

Last Name

Emergency Phone Number (Best Number to Reach You)

Allergies or other medical information

Is there anything you want us to know about your child?

Child's Doctor/Practitioner

Doctor/Practitioner's Phone Number

I hereby give Connecticut Art School staff permission to see that my minor child receives medical treatment in the case of an emergency

I agree

ADDITIONAL RELEASES & POLICIES

I hereby give Connecticut Art School permission to use photos of my child (identified only by first name and age) in promotional materials including printed pieces and social media

Yes

We're excited to create with you at this paint party. If you have any questions, please email Ashley at info@ct-artschool.com.