Youth Registration at the Morris Graves Museum of Art 
After School/School Break Art Classes/Museum Art School Registration Form
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Email *
Select the Art Session below for registration *
Student's Name *
Student Age *
Student Grade
Student's Preferred Pronouns
Parent or Guardian's Name *
Parent or Guardians Phone Number  *
Parent or Guardians Email  *
Please tell us how you heard about this class/camp?
Where does your child attend school?  *
What visual or performing arts classes has your child attended previously? 
What visual and performing arts opportunities does your child have in their school classroom? 
Emergency Contact Information (other than Parent/Guardian listed above) *
Emergency Contact Phone Number *
Relationship *
Address *
Family Physician Name *
Physician Phone Number  *
Health Insurance Plan *
Primary Policy Holder's Name  *
Group Number *
Policy Number  *
Include here any information about allergies, physical accommodations or modifications, behavioral accommodations or modifications, seizures, etc.   *
Would you like to sign up for the Education Newsletter to stay informed about upcoming classes and workshops?
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Release of Liability 

The Humboldt Arts Council in the Morris Graves Museum of Art reserves the right to change, withdraw, or modify a class at any time, as well as to withdraw any participant whose conduct is deemed detrimental.  The Museum’s Staff, volunteers, or Board of Directors cannot be held liable for personal injury or loss, theft, or damage of personal property.  Signature on registration form implies understanding of all policies noted in this publication.

Hold Harmless Agreement: In consideration of being permitted to participate in the Humboldt Arts Council Studio Art Classes at the Morris Graves Museum of Art, I agree to assume all risks connected therewith. I agree to release and discharge in advance the Humboldt Arts Council, its officers, employees, and agents from any and all liability for personal injury.  I also assume full responsibility for myself and the minor child registered under my signature’s behavior.  If a participant’s behavior interferes with the program, I understand that expulsion from the program is a possible consequence. In addition, I understand that classes are held on the premises of the Morris Graves Museum of Art and that included in this, is the risk that registered participants including minor children, will see works of art with mature themes.  I acknowledge and accept responsibility for this possibility.

Late Pick-up and Cancellation Policy: Please notify our office if you are late to pick-up your child. After a 15 minute grace period, we will charge $10 for every additional ten minutes.

Refund/Cancellation Policy: For a refund of tuition for classes or camp, cancellations must be made no later than two weeks before class/camp begins. A refund will not be offered with less than two weeks’ notice of a cancellation.

Permission for Medical Treatment: In case of an accident or injury, I authorize the Humboldt Arts Council to take the necessary action to protect the well-being of myself or the minor child registered under my signature.  I give my consent to any medical treatment felt necessary by an attending physician for the physical well-being of myself or the minor child, and understand that any emergency treatment deemed necessary by the responding emergency team is at my own expense.

Consent to Photograph, Film, or Tape: I agree to have photographs, films, video tapes, or tape recordings taken of me or the minor child registered under my signature while participating in the Humboldt Arts Council Studio Art Classes at the Morris Graves Museum of Art. I permit these photographs, films, or tapes to be used in publications, promotional materials, website, and for other purposes by the Humboldt Arts Council.  If I do not consent, staff leading the program for which I am registered must be informed of and record my non-consent.

I have read and understand all registration requirements and policies, including the late pick-up and cancellation policy.

 

Participant/Guardian Signature and Date 

(Please type your name and submit this form to indicate that you agree with the conditions stated above.)
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