CAC Summer Arts Camps - Child Information Form

Event Address: 1217 Menoher Blvd. Johnstown, PA 15905
Contact us at (814) 255-6515 or caccc@atlanticbbn.net
Parent/Guardian Name(s) *
Your answer
Child's Name *
Your answer
Child's Age & Grade (18/19 School Year) *
Your answer
Phone Number *
Your answer
Email *
Your answer
Home Address *
Your answer
Emergency Contacts (Name, phone #, and relationship to child) *
Your answer
Does your child have any known health conditions? *
If "yes", describe:
Your answer
Does your child need regular medication for health conditions?
If yes, what and when is it administered? (Please note, the Community Arts Center, its staff, and its volunteers are not permitted to administer medication of any kind.)
Your answer
Does your child have any allergies?
Your answer
Does your child have any learning or physical conditions that our staff should be aware of?
Your answer
I give my permission for CAC staff to assist my child in applying sunscreen that I provide. *
I give my permission for CAC staff to assist my child in applying insect repellent that I provide. *
I understand that I will have to pay online at caccc.org before/after submitting my registration. *
Required
I have read and understand the parent information guide that is available for download at caccc.org. *
I give my permission for photos or videos to be taken of my child which may be used for promotional purposes in printed media, social media, and broadcast media. *
Required
I/we understand and agree on behalf of my/our minor child and/or other individual over whom I/we have guardianship (hereinafter “minor”) that the Community Arts Center of Cambria County and its directors, employees, instructors, and volunteers will not be responsible nor liable for any damage and/or loss and/or injury to persons and/or property occurring during my/our minor’s participation in this class, camp, workshop, seminar, show, event, etc. I/we understand my/our minor is participating in this class, camp, workshop, seminar, show, event, etc., at my own risk. Furthermore, I/we understand that the Community Arts Center of Cambria County reserves the right to refuse entry and/or service, and/or to remove artwork, artists, patrons, or spectators at their sole discretion in order to maintain a family-friendly environment, and for the comfort and safety of other participants and patrons. I/we understand and agree that I/we shall be responsible for the conduct of my/our minor and any injuries or damage incurred due to the minor’s actions or negligence. *
By submitting this form, I authorize that I agree to pay for all Art Care services in advance. I have informed the Community Arts Center of Cambria County of any physical, social, emotional, or health conditions my child has that could affect their participation in any or all activities or with other children. *
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