A Day of Art at the Mennello Museum Registration Form - Middle School 8.5.19
This year, finish your summer with a back to school art party at the Mennello Museum of American Art. Have the museum to yourself and your friends to create large scale portraits of swirling ink silhouettes, write your own poetry, play with the fiber arts and tear up books inspired by artist on display Firelei Baez. All of your art will be ready to take home with you and show off on your first day of school. The Days of Art will be led by Creative Arts Therapist, Lulu Figueroa. Middle School perfect for those entering grades 6-8 in 2019.

Day of Art 9:00 am - 4:00 pm

Drop off begins 8:30 am - Pick up begins 4:00, Last Pick up 5:30 pm

$45 Member | $50 general

Student Name *
Your answer
Parent or Guardian Name(s) *
Your answer
Phone Number(s) *
Your answer
Email(s) *
Your answer
In case of emergency who should we contact and at what phone number(s) *
Your answer
Pick up and Drop off Contact Name(s) and Number(s) *
Your answer
When will your child be picked up for the day? *
I understand the bagged lunches and snacks are required to be brought by each camper *
I have or will pay the camp fee of $50 (non-museum-member) or $45 (museum member) *
The Mennello Museum of American Art, its agents, and employees do not administer oral or topical medications. Children must be able to administer or take medication by themselves. The following information must be filled in by the caregivers to provide Museum Staff the background to provide appropriate care. Provide complete information so that the camp can be aware of your child's needs.
Is the camper covered by family medical/hospital insurance?
If yes, would you like to provide medical information in case of an emergency? Family Physician Name | Clinic Name | Physician/Clinic Phone | Address | Insurance Company | ID Number | Group Number
Your answer
Does the Camper have any known food, medical or other allergies? If yes, list *
Your answer
Send only medications that absolutely must be taken during camp. Must be in original package or bottle and placed in a Ziploc bag labeled with the child’s name. Must have a prescription label with (1) camper’s name and (2) dosage clearly printed. Must not be expired Medication will not be accepted if they fail to adhere to these guidelines. Please list all medications taken routinely and the reason for taking the medication:
Your answer
Does camper carry and emergency pen or inhaler? *
I attest that all immunizations required for school are up to date for the camper *
Date of last tetanus shot (Tetanus is usually included in the shot for Diphtheria and Pertussis [Whooping Cough]) *
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