2025 Summer Camp Registration Form

Health Information
In case of emergency, or if you cannot be reached, the child's or family's physician is: *
Hospital Preference: *
Do you have health insurance?*

Acknowledgements
In the event of an emergency, I authorize the Art Museum of Southeast Texas, its agents & employees to obtain medical treatment necessary to insure the health and well-being of my child(ren).*

YesNo
I authorize the Art Museum of Southeast Texas, its agents & employees to administer children's Benadryl in the event of an allergic reaction.*

YesNo
I hereby allow the Art Museum of Southeast Texas to take photographs of my child(ren) to be used for AMSET public relations and archival purposes only.*

YesNo
Person other than yourself that YOU authorize to take your child(ren) from the Art Museum of Southeast Texas building & grounds (list name and relation) :*
Phone Number of Authorized Person: *
Please enter a valid phone number.
Additional authorizations (please list name, relation, and phone number):
You should be aware of our disciplinary policy. It is simple and firm:

Your child will not be allowed to disrupt the art experience of any other child. In the event that your child continuously causes a disruption, he/she will be dismissed from Summer ArtVentures. You will be contacted and expected to collect your child immediately.

Your money will not be refunded.
Parent's Signature Required: *

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Summer ArtVentures 2025