[Imported] BUNKER REGISTRATION FORMS 2024/2025

EMERGENCY CONTACT INFORMATION
Emergency Contact #1 Name*
Relationship to child?*
Primary Phone Number*
Please enter a valid phone number.
Cell Phone Number
Please enter a valid phone number.
Emergency Contact #2*
Relationship to child*
Primary Phone Number*
Please enter a valid phone number.
Cell Phone Number
Please enter a valid phone number.

Child's Information
Child's name*
Child's pronouns*

She/HerHe/HimThey/ThemOther
Birthdate*

MonthDayYear
Grade*
Does your child have any allergies, chronic illness, or medical conditions?*

YesNo
If yes, please describe:
Is your child prescribed an inhaler or an epipen?*

YesNo
Please provide the name of medication and instructions (If any).
Does your child have any special physical, behavioral, learning, and/or other needs our staff should be aware of?*

POLICIES AND EXPECTATIONS
Statement of Purpose

Northwind Art School believes that art promotes the well-being of individuals, community, and the world. Your child is invited to join us in learning, growing an artist’s mindset, and cultivate their art practice in a safe space. We foster a creative community – instigating joy, self reflection and exploration, connection, learning, and the furthering of skills through art.

Fostering a safe space requires commitment from our Teaching Artists, Staff, and our students to provide supportive, respectful, kind, and empowering interactions between anyone who participates in our programming, regardless of race, sexual orientation, gender identity and expression, ability, age, or socioeconomic status. A safe space for everyone means that we as a community are willing to engage in self reflection, receive feedback, and remain curious of how our words and practices impact those around us. Together we will grow and improve in response to the needs of the individuals in our arts community and school.

Thank you for joining us in filling our school with joy and enlivening the creative spark within all who cross our paths.

Youth Policy

In order for Northwind Art School to remain a physically and emotionally safe space for young people, students under the age of 18 will not be alone with an adult (other than a legal guardian) on campus. To ensure this we will plan youth programming so that there is always more than one adult on campus for the entirety of the program. We will make sure that pickup happens in a timely manner. It is essential that you pick your child up on time. If a family consistently picks their child up late, your child will not be invited back to Bunker

Code of Conduct

TREAT OTHERS AS YOU WOULD LIKE TO BE TREATED

BUNKER participants are expected to:
● Treat others the way in which we would like and expect to be treated. Please do
not use words or actions that are disrespectful or mean.

● Know and exercise positive modes of behavior and good manners. Running and
making loud noises is inappropriate. Refrain from activities that can be physically
dangerous to one’s own self or others. Do Not damage or destroy things at BUNKER
or things that belong to other students including art work.

● Respect the rights of others, including the right to enjoy the art activity in an
environment that is orderly and disciplined. Staying attentive during art instruction
times so everyone can benefit from listening to guided directions
.
● Accept the responsibility for their actions and the consequences of
inappropriate behavior.

A participant's negative behavior has significant impact on other participants and the longevity of the program. To ensure the safety of everyone, and to meet the goals of our program we will follow the proceeding plans in regards to teen communication and participation in the Bunker Program:

1. Oral warning.
2. Phone call home to a parent.
3. Not invited back to Bunker.
By clicking yes, you confirm that you have read and understand the expectations of our teen participants and the process we will follow to communicate with families about behavior that challenges our code of conduct norms. *

Yes
AUTHORIZATIONS AND RELEASES
General Authorizations

I confirm the authorizations and consent to the details within this document, including, but not limited to medical treatment, field trips, activity participation, and emergency contacts.
(Please Initial).*

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Authorization of Treatment

I give permission for Northwind Art Teaching Artists, volunteers and staff (now referred to as Northwind Art and its personnel below) to provide any medical assistance they deem appropriate for my child.

I also give permission for any emergency personnel to treat my child in the event of an emergency and understand that I will be responsible for all medical expenses that may be incurred as a result.
(Please Initial).*

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Northwind Art Policies

I have read Northwind Art’s guidelines outlining all youth program policies and procedures and understand and will comply with all program policies and procedures.

I understand that should my child violate these policies or procedures, or act in a manner that is unsafe for my child, other participants or staff, my child may be excluded from the program. Accordingly, I have told my child to obey all directions of staff, to comply with all safety instructions and to refrain from unsafe practices.
(Please Initial).*

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Media Release

I understand that by selecting yes to the question below, photos, videos, and audio recordings of my child may be taken during Northwind Art courses and camps. I hereby authorize Northwind Art and its personnel to take, use, and publish photographs, video, and audio records of my child for education, public relations, marketing and purposes related to Northwind Art.
Please indicate whether we can use images of your child for promotional purposes*

YesNo
General Release

I acknowledge that there are natural hazards associated with youth programming, art courses and camp programs, and related activities in both indoor and outdoor settings. I acknowledge that Fort Worden is an old building and that my child may come into contact with hazards associated with such spaces.

I hereby affirm that my child is in good health and physically capable of performing the required activities. In consideration of Northwind Art accepting my child into a program, I hereby assume all risks associated with my child’s attendance and participation.

I will indemnify, hold harmless and release Northwind Art, their employees, volunteers, interns, and agents from all liability, actions, causes of action, debts, claims, demands or other liability of every kind and nature whatsoever which may arise from or in connection with my child’s participating in any activities sponsored through Northwind Art, including, and without limitation, any damages or injuries which may be sustained while my child is at camp.

I understand and agree that this release is intended to be as broad and inclusive as is permitted by the laws of the State of Washington, and that if any portion of it is held to be invalid, I agree that the remaining terms shall continue to be in full legal force and effect.
Please Initial*

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Legal Guardian Name*

First NameLast Name
BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER
SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Todays Date*

MonthDayYear
Date
Legal Guardian Signature*

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BUNKER REGISTRATION FORMS

Guardian and Participation Information

EMERGENCY CONTACT INFORMATION

Child's Information

POLICIES AND EXPECTATIONS

AUTHORIZATIONS AND RELEASES