Collins Artworks Art Center - Kids Art Classes Registration

Collins Artworks Art Education Center Student Registration

You can register your child for our after school, home school or school vacation art classes by filling out this form and clicking the Submit button.

Name of Student:	Date of birth:
Street address:
City:	State: Zip code:
Phone:	Cell phone:
Father's Name:	Work Phone: Cell Phone:
Father's E-Mail:
Mother's Name:	Work Phone: Cell Phone:
Mother's E-Mail:
Siblings:	Age: Age:
	Age: Age:
Learning problems:
Allergies:

Other adults who may pick up your child (ID will be required)

Name:	Address: Phone:
Name:	Address: Phone:

Name of friend(s) or relative(s) in the area who may be notified if unable to locate parent(s). If a child becomes sick while at the center, the child MUST be picked up and taken home, if not picked up by you then by someone else. No exceptions.

Name:	Address: Phone:
Name:	Address: Phone:

I will notify the center if there is a change in the above arrangements. In case of an emergency, I understand the center will try to contact the parent. In the event that the parent cannot be reached, permission is given for the Art Center to take my child to an emergency hospital by ambulance if necessary.

I grant permission to the Art Center to take photographs of my child for the sole purposes of advertising, scrapbooking, and/or inclusion in local newspaper articles:
Yes: No:

Signing up for:

I grant permission to the Art Center to transport my child from school to the Art Center:
Yes: No:

Note that you will need to sign the paper permission form before your child can start attending classes.