Cosmic Creations Art Camp Registration Form

Medical Information
Does the artist have any allergies, chronic illness, or medical conditions? If yes, please describe. (Especially Food allergies) PIZZA DAY IS FRIDAY!*
Please explain on the field provided including any food the camper is allergic to
Is the camper currently under medication? *
Please provide the details, the name of the medication and period of intake
Disabilities Policy – It is Daydream Art/The Fine Arts Center of Easley sincere wish that our programs be open and accessible to all participants, regardless of ability. Daydream Art/The Fine Arts Center of Easley is open to enrollment of camp participation with disabilities on a trial basis. This is done with the understanding that some participants may require the presence and assistance of a parent or guardian to provide additional assistance. If at any time Daydream Art/The Fine Arts Center of Easley staff feels that the participant is experiencing ongoing challenges or difficulties in the camp environment that have a disruptive effect on the group, Daydream Art/The Fine Arts Center of Easley reserves the right to ask that participation be discontinued.

Contact Information in Case of Emergency
Name*

First NameLast Name
Contact Number*
Relation to camper*
Name

First NameLast Name
Contact Number
Relation to camper
Medical Release and Authorization

As Parent and/or Guardian of the named camper, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.

Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named artist. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.

Permission is also granted to Daydream Art/The Fine Arts Center of Easley and its affiliates including Directors, Teachers, Principals or Coaches to provide the
treatment prior to the child’s admission to the medical facility.

Release authorized on the dates and/or duration of the registered season.

This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.

Due to the popularity of art camps, be sure to REGISTER early to not miss out, as spaces fill up fast! Fun, Materials and instructions will be provided!!

🎨Camp is limited to 20 campers. A minimum of 5 campers are required for the camp to make. In the event camp is cancelled, a full refund will be provided to those registered.

🎨We do T-shirt painting, canvas painting, wood painting, multi-media art, ceramics, paper projects, and watercolor! FUN arts and crafts!

🎨WHAT TO WEAR: Have your child(ren) wear play/paint clothes.

🎨SNACK: Pack a snack and a lunch for Monday thru Thursday. Please label bags and cups with campers's name. Only pack a snack on Friday for "Pizza Friday!" 🍕🍕🍕

🎨AGE POLICY: Art Camp is open to ages 8 to 12 years of age

🚶WALK- INS: We do not take Walk-ins. We prepare for each child well in advance.

Invoice Reserves your childs spot!

🚗BEFORE and AFTER CARE: We do not provide before and after care. Drop off is between 8:45 am and 9 am. The pick up is between 12 pm and 12:15 pm.

🎨BEHAVIORAL POLICY - It is very important to let us know if there are any medical or behavioral issues with your child that will affect his/her participation and how we interact with him/her. We want to give every child the best experience possible in a group setting!

If we've taken corrective action, and the behavior does not improve, we will contact
parents/guardian in attempts to correct the behavior. If it is still not corrected,
parent/guardian will be called and asked to pick up their child. No exceptions.

PLEASE NOTE: Elimination from the camp for any amount of duration (half day, full day, week, etc.). There will be no refunds in this instance.

🎨CANCELLATION/REFUND POLICY - Cancellation with full refund (minus any transaction fees) is given only up to the 2 weeks before Camp Session (by June 20, 2025). Cancellations after June 20, 2025 are non refundable, however we will provide you with DIY art kits for the projects to be picked up on Friday!
Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by Daydream Art/Denise Day during the selected camp. In exchange for the acceptance of said child’s candidacy by Daydream Art/Denise Day, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Daydream Art/Denise Day/The Fine Arts Center of Easley and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions.

In case of injury to said child, I hereby waive all claims against Daydream Art/Denise Day/The Fine Arts Center of Easley including all affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event.

Confirmation

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.
Date*

MonthDayYear
Date
Typing your name here serves as your signature.
Name*

First NameLast Name
Should be Empty:

Summer Art Camp Application

Medical Information

Contact Information in Case of Emergency