MuseumLab After School Registration Form
Student Name
First Name
Last Name
Student Preferred Name
Student Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Student Email
example@example.com
Student Date of Birth
Student School
Student Grade
Student Preferred Pronoun (she/her, he/him, they/them)
Student Interests
Have you been to MuseumLab before?
Throughout the year we'll be exploring a wide variety of art and making processes. In which, if any, do you have previous experience? Check all that apply.
Traditional 2D arts (drawing, painting, cartooning, etc)
Fiber arts (sewing, embroidery, weaving, etc)
Digital arts (animation, laser cutting, 3D printing, etc)
Writing (poetry, short stories, etc)ption 4
Sculpture (clay, paper cache, metals, woodworking, etc)
Other
What art and making processes are you interested in learning? Check all that apply.
Fiber arts (sewing, embroidery, weaving, etc)
Sculpture (clay, paper cache, metals, woodworking, etc)
Traditional 2D arts (drawing, painting, cartooning, etc)
Printmaking (silkscreen, block printing, etching, etc)
Other
How does art play a role in your everyday life?
Participants in After School at MuseumLab will learn from artists, while exploring current issues through a social justice lens. When you think of social justice, what does that mean to you?
How could you contribute to making MuseumLab's After School program feel more inclusive or welcoming for other kids?
Why does a program that combines art and social justice interest you?
Your acceptance into the After School program will be based on your interest in art and making. Please submit an image of artwork you completed.
Browse Files
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of
Please submit a picture of artwork you are still working on.
Browse Files
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Choose a file
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of
What else would you like us to know about you?
For Parent/Guardian To Complete
Contact Information
Parent/Guardian Name
First Name
Last Name
Parent/Guardian Email
example@example.com
Parent/Guardian Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Guardian Address (if different from student)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
After School at MuseumLab will meet Monday through Friday. As the program builds itself over time, is your child able to commit to attending at least two days per week?
Yes
No
How will your child get to and from After School at MuseumLab?
List the names of people who are allowed to pick up your child from After School at MuseumLab (ID will be required to pickup inside MuseumLab).
How did you hear about After School at MuseumLab?
EMERGENCY CONTACTS
Emergency Contact #1 Name - Please list someone other than the parent or guardian of the student
First Name
Last Name
Emergency Contact #1 Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact #1 Email
example@example.com
Relationship to Student
Emergency Contact #2 Name
First Name
Last Name
Emergency Contact #2 Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact #2 Email
example@example.com
Relationship to Student
Submit
Should be Empty: