Registration for Delphi Opera House Art Enrichment Program Summer Session 2023
Use this form to register students for the Summer 2023 session of the Delphi Opera House Art Enrichment Program for Children and Youth. Classes will be held June 13, 15, 20, and 22 (Tuesday-Thursday), from 9:30 - 11:30 am. All classes are free and will be held at the Delphi Opera House at 109 S. Washington Street, Delphi, IN.  If you need assistance completing this form please email barb.mayfield@gmail.com or call 765-414-4376.
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Email *
Student Information
Student First Name
*
Student Last Name *
Student Street Address *
Zip Code *
Student's Grade Level (grade entering Fall 2023) *
Student's School
(if homeschooled, answer homeschool)
*
We have the potential for free bus pick-up and drop-off at student's homes if there is a need. Please indicate your transportation plans:
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Please list any health concerns, disability accommodations, or other special needs. Include any food allergies (we will have mid-morning refreshments). *
Parent/Guardian Information
Parent/Guardian Name (First Last)
*
Parent/Guardian Phone Number *
Demographic Information
This information is kept entirely confidental and used only for reporting to the Indiana Arts Commission and the National Endowment for the Arts.
Student's Gender
*
Student's primary race *
Does the student qualify for the free or reduced school lunch program? *
Select one class for your student  *
Students who are new to the art enrichment program will receive a free t-shirt, please select your child's size:
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Participation Waivers and Guidelines
Attendance in 100% of the classes in a session is expected and if students do not show up without prior notice of the reason for non-attentance, their spot may be given to a student on the waiting list and they will forfeit their spot.

Respect for self, others, and property is expected and the demonstration of disrespect through words or actions may result in removal from the program if a warning is ineffective.

Photography Permissions
My student and I grant the Delphi Opera House, its employees, contractors, volunteers, and participating organizations, full access and use of any photographs, video, or other media showing the student while participating in this program. I understand these photographs may be used by DOH for promotion of the Arts Enrichment Program.
***Note that if you do not want your student photographed, please notify us at admin@delphioperahouse.org

I have read and understood the above information regarding the participation guidelines for Delphi Opera House's Art Enrichment Program.
*
Signature - Type Parent/Guardian Full Name *
Thank you! Please submit your answers.
A copy of your responses will be emailed to the address you provided. 
A copy of your responses will be emailed to the address you provided.
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