Arts & Activism Program Registration – Ollie Burns Library
This form is for youth ages 12–18 to register for the Arts & Activism Program hosted at Ollie Burns Library in partnership with Choices Mentoring for Families and Youth. The program provides arts education, performance training, and community engagement. All participants and guardians must review and agree to the expectations below.
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Participant Full Name
Participant Address
Parent/Guardian Full Name
Parent/Guardian Phone Number
Parent/Guardian Email
Emergency Contact Name
Emergency Contact Phone
Food Allergies/Dietary Restrictions (Type 'None' if not applicable)
Art Interest (Select all that apply)
T-Shirt Size
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Code of Conduct & Behavior

Participants are expected to maintain a respectful, safe, and positive environment at all times by treating staff and peers with respect, following instructions, and using appropriate language and behavior. Cursing, inappropriate conduct, or disruption will not be tolerated. All equipment must be handled responsibly; mishandling will result in a written warning and may lead to removal if repeated. The disciplinary process includes a verbal warning, followed by a written warning, and then removal from the program for continued violations. Fighting or any physical altercation will result in immediate removal from the program. By agreeing, I understand and accept these expectations and consequences.


Code of Conduct & Behavior Agreement
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Participant Signature (Type Full Name)
Parent/Guardian Acknowledgment
Submit
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