Art Class at the VAC
2022 Winter Classes
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Available Classes *
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Please contact me about scholarships *
Student name *
Date of birth *
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Parent(s)/Guardian(s) name *
Email Address *
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Secondary phone
Emergency contact name *
Emergency contact primary phone *
Emergency contact secondary phone
Medical conditions and allergies *
Dietary restrictions and allergies *
Anything we need to know regarding child/or special considerations. *
I understand masks are required indoors unless eating or drinking. *
MEDICAL RELEASE I agree to allow my child to receive medical treatment, should the need arise. I also give permission for my child to be transported to the nearest hospital in the event of a medical emergency. As parent and/or guardian of the above named child, I promise to hold Oregon Coast Council for the Arts harmless from any liabilities it may incur from the above named minor in connection with participation in art classes except as might arise because of negligence on the part of the Oregon Coast Council for the Arts.
Parent/Guardian Name *
Child Name *
Typing my name below will constitute by signature *
Relationship to child *
Date *
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PHOTO RELEASE I give permission for my child to be photographed and/or videographed in  Oregon Coast Council for the Arts activities. I understand and agree that all rights to these photographs and videos are reserved by and shall become property of the Oregon Coast Council for the Arts, and may be used by the Oregon Coast Council for the Arts, for promotion and publicity by the Oregon Coast Council for the Arts, including on the website, in print media, on television or online.   *
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