Summer Camp program Parental Release / Medical Information / Code of Conduct

2023 ARTrageous Camp Program Registration /Parental Release / Medical Information / & Code of Conduct

Complete this online form. You will need the student present for the Code of Conduct section.
ARTrageous

Our open-studio learning format remains a unique opportunity for the young artist, and is great experience for all levels wishing to explore the visual arts.There is a casual, relaxed manner about our art camp, packed with materials, run by an experienced, creative staff. Our dedicated team of artsy educators will spark your child's imagination with a wide variety of engaging projects, from drawing and building to sculpture, mixed media, and more! Small snacks are provided. Children may bring a packed lunch to store in the refrigerator and warm up in the microwave. Space is limited as we will only accept 12 children for our program as this camp is geared towards youth who have a desire and ability in the arts. If your child truly does not show interest in the arts, they may not take this program seriously, please reconsider signing them up the following year.
Cost

The cost is $50 per day. Enjoy a discount when you register for all 3 days!
Campers Information
Child's Name

First NameLast Name
Child's Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Child's age
General Information
Elementary School or Middle School
Which day/(s will your camper be attending?

Other
Parental Consent
Parent or Guardian of the above named minor releases ARTrageous, its representatives, agents, servants, and employees from liability for any injury to said minor, resulting from any cause whatsoever occurring to said minor at any time while attending the program, including travel to and from camp and any field trips, accepting only injury or damage resulting from willful acts of such representatives, agents, servants and employees. ARTrageous Brush & Flow is also released of any expenses resulting from the injury.

Your child will have the opportunity to participate in activities outside of the studio, including, but not limited to, local field trips. ARTrageous will provide trained staff who will conduct all activities in the safest manner possible.

Children and parents are expected to be familiar with all program policies. To protect the safety of all campers, ARTrageous has no-tolerance policiy that could immediately result in students being sent home without a refund. These policies, include, but are not limited to:

1. Use of violence or possession of weapons

2. Use of alcohol or drugs

Parents or guardians of students who violate policies will be notified to pick up their child.

During the days of the program, we will be taking pictures and videos. Please contact us if you have a need for exclusion.

ARTrageous will have first aids kits on site as well as a traveling kit that will travel with us when outside out the studio that will treat for basic injuries and illnesses. Reports will be filed before the camper leaves camp.
Parental Consent: Parent/Guardian Signature
Date of Signature

MonthDayYear
Date
Student Medical Information
Student Date of Birth

MonthDayYear
Date
Do you have Health Insurance coverage for the camper?
Health Insurance Company
Health Insurance Policy Number
Does the camper have any allergies?
List all allergies and the type of reaction they cause
Does the camper have an epi-pen? If so, they must keep it with them at all times!
Does the camper have any special food restrictions?
Please list any special food restrictions
Does the Child take any medications they will take during the day of the program?
IMPORTANT: All medications must be in the original package (daily sorters/pill keepers are not permitted.)

Please only send enough medication for the day.
Type a question
List medications and when they must be taken (example: At Lunch, As Needed)
Has the the child been diagnosed with asthma by a physician?
IMPORTANT: If your child has been diagnosed with asthma by a physician and has an inhaler, they must keep it with them at ALL TIMES during the program!
Does the child have any other significant health history (heart condition, diabetes, any injury) or does the child have any restrictions/medical conditions that the CKC staff needs to be aware of?
If Yes, please explain
Over the Counter Medications Permitted

Over the Counter Medications Permitted
May we give your child if needed...
Neosporin?
Polysporin?
Emergency Contacts
Primary Contact: In case of emergency, please contact the following person

First NameLast Name
Primary Contact Relationship to child
Primary Contact Home Phone Number

Area CodePhone Number
Primary Contact Cell Phone Number

Area CodePhone Number
Primary Contact Work Number

Area CodePhone Number
First NameLast Name
Secondary Contact relationship to child
Secondary Contact Home Phone Number

Area CodePhone Number
Secondary Contact Cell Phone Number

Area CodePhone Number
Secondary Contact Work Number

Area CodePhone Number
Medical Information Signature
I have read and understand the statements in this release form. I understand that should a health problem arise, I will be notified but if I cannot be reached by telephone I consent to emergency medical treatment for my child as deemed necessary by competent medical personnel. I also consent to the release of information for insurance purposes.
Parent/Guardian Name

First NameLast Name
Medical Information: Parent/Guardian Signature
Date of Signature

MonthDayYear
Date
Student Code of Conduct

This section must be completed by both the Child and a Parent/Guardian. Please read this section together.
As a young artist attending The ARTrageous Brush & Flow Camp, I agree that:
- I understand that I am attending ARTrageous and will conduct myself in a manner that positively represents me, my family, and my school.
- I understand that ARTrageous will focus on art and creating I will be open-minded and willing to learn about other cultures and countries besides mine.
- I will participate in the program, display a positive attitude, and conduct myself appropriately at all times.
- I will respect all children, advisors, and staff. I will follow instructions from all adults and camp staff.
- I will not use a cell phone during programs and activities unless instructed.
- I will follow the dress code.
- I will remain in the presence of my instructor while at camp.
- I will not bring highly valuable items to camp. If I do bring valuables, I accept full responsibility for those items.
- I will not use language or behavior that is obscene, violent, or racially or sexually inappropriate.
- I will not possess or use tobacco products, alcohol and/or drugs.
- I will not possess or use firearms, weapons, and/ or pocket knives.
- I will respect ARTrageous Studio property by keeping the facilities clean, not creating graffiti on studio property , and not using items that are not meant for creating art. I accept responsibility for damages I cause.
I understand that failure to meet with these standards will result in these steps:
1. I will call my parents/guardians and report my conduct that was not in compliance with these guidelines.
2. At the Director’s discretion, this may result in my parents/guardians arranging transportation home.
I also understand that if I fail to follow no-tolerance policies, the following steps may be taken:
1. I will be removed from the facilities.
2. Law enforcement will be contacted.
3. I will be suspended from all activities at the ARTrageous program
Student Commitment:

I have read and understand the Code of Conduct above. I agree to abide by it for the safety and enjoyment of myself and of other campers. I understand the consequences of failing to meet these guidelines.
Code of Conduct: Parent/Guardian Signature:
Date of Signature

MonthDayYear
Date
Parent/Guardian Email Address:
My Products
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Camp week$130.00
Covers a 3 day ARTrageous Camp Week . Tuesday, Thursday, and Friday.

Days

Registration$35.00
registration fees cover a comprehensive range of expenses essential for providing a well-rounded and enriching experience for campers. These fees contribute to various aspects of the camp.

Total $0.00

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2023 ARTrageous Camp Program Registration /Parental Release / Medical Information / & Code of Conduct

ARTrageous

Cost

Campers Information

Parental Consent

Student Medical Information

Over the Counter Medications Permitted

Emergency Contacts

Medical Information Signature

Student Code of Conduct

My Products

Payment Methods