MWCA Student Information Form

👋 Welcome!
This is an information form for children and teens in our classes and camps. This is not the registration/payment. Please complete the registration and payment through our website or with Donna and Rebecca, who handle their own registrations.

We’re excited to create a fun, safe, and enriching experience for your young artist.

To help us do that, we ask that you take just a few minutes to complete this short form. Your responses help us get to know your child better, prepare for any needs they may have, and ensure that everyone has a great time.

💛 This form is required before the first day of class or camp — thank you for helping us create a positive, creative space for all!

If you have any questions, feel free to reach out to us. We’re looking forward to a wonderful experience with your child!

If a question does not apply to your child, please write "None".

Please carefully read the STUDENT & CLASSROOM Policies HERE

— The MWCA Team 🎨

What class(es) or camps are you registering for?*

Name of student*

First NameLast Name

Preferred name or nickname?

Age of student*

Birthdate*

Date

Allergies or medical conditions we need to be aware of?*

Medications we should know about?*

Sensory, behavioral or learning considerations?*

Anything else we should know to help your child have a great experience?

yesno

Parent/Guardian Name*

First NameLast Name

Phone Number*

Area CodePhone Number

yesno

Email*

example@example.com

Other emergency contact - name & phone #*

Authorized Pick-up List *

yesno

Date *

Date

I have carefully read and agree to MWCA Student & Classroom Policies (linked above) and this "behavior" policy: Students are expected to behave in an age-appropriate manner. They should treat instructors, classmates, and supplies with respect. If ongoing behavior issues arise, a parent may be asked to attend with the student. We reserve the right to suspend participation if the class is not a good fit.*

yes

Signature

Waiver and Hold Harmless Agreement --- By enrolling in classes, workshops, camps, or events at Monroe-Walton Center for the Arts (MWCA), I acknowledge and accept all risks associated with participation. I agree to release, indemnify, and hold harmless MWCA, its staff, instructors, volunteers, and board members from any and all liability, claims, demands, and causes of action arising out of or related to any loss, damage, or injury, including illness, that may occur while participating in MWCA activities.I understand that MWCA is not responsible for providing medical care, and in the case of an emergency, I authorize MWCA staff or volunteers to seek emergency medical treatment on behalf of the participant, if necessary.*

Yes, I understand and agree

MWCA Student Information Form

Parent/Guardian Information

Miscellaneous