Poetry for Teens Workshop, October 1, 2025, 6:00-7:30pm

Poetry for Teens | Registration Form (9th-12th grade)

October 1, 2025, Wednesday | 6:00-7:30pm | Lorena de Luna | FREE | Location: Bath House Cultural Center, Classroom | 521 E. Lawther Dr. Dallas, TX 75218
Student Name:*

First NameLast Name
Student Age:*
Guardian Name:*
Guardian Phone Number*

Area CodePhone Number
Guardian Email*
example@example.com
How did you hear about the workshop?*

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Poetry for Teens| Parental Agreement

As a parent/guardian of a student attending Poetry Workshop for Teens, Grades 9th-12th on Wednesday, October 1, 2025, I agree to the following:

· I will be responsible for the transportation of my student to and from the Bath House Cultural Center. My student will arrive at the center on time.

- I, parent/guardian, will stay nearby for this class, allowing my child to sit with the other students to build self-esteem and skills in the art studio.

· I give the Bath House Cultural Center permission to use images of my student for future publications, website, or promotional material without any compensation to my student or me.

· I understand that my student is expected to behave in a respectful and proper way throughout this class (ie: no fighting, no cursing, no stealing, etc.) Should my student continually misbehave or disrespect the faculty/staff, I understand that I will be contacted to come and remove my student from the program.

· I release the Bath House Cultural Center of any liability should my student become injured while attending class.

· I understand that my involvement in this process is integral to the success of my student and the entire process of the class.
If I am unable to transport my student, I will make arrangements and my student may be released to:
Name and Relation (Skip if not applicable.)
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Poetry for Teens | Registration Form (9th-12th grade)