Sparkalicious Craft and Enrichment Club

Sparkalicious Craft and Enrichment Club

Contact Information and Waiver
Student Information:
Child's Name

First NameLast Name
Date of Birth:

MonthDayYear
Date
Parent/Guardian Information:
Parent/Guardian Name:

First NameLast Name
Relationship to Child:
Home Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email Address:
example@example.com
Phone Number:
Please enter a valid phone number.Format: (000) 000-0000.
Allergies and Special Needs:
Does your child have any food or other allergies?
If yes, please list:
Does your child have any special needs or requirements?
If yes, please describe:
Emergency Contact:
Name:

First NameLast Name
Relationship to Child:
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Consent and Liability Waiver:
I, the undersigned parent/guardian, hereby grant permission for my child to participate in the Sparkalicious Craft and Enrichment Club. I understand that while the club will take reasonable care to ensure my child's safety, there are risks associated with any activity. I release and hold harmless Sparkalicious, LLC, its owners, employees, and agents from any and all claims, demands, or causes of action that may arise from my child's participation in the club.

I understand that my child will be engaging in activities that may involve art supplies, materials, and equipment, and I acknowledge that there are risks associated with these activities. I agree to hold harmless Sparkalicious, LLC for any injuries or damages that may occur as a result of my child's participation.
Additional Information:
Is there any additional information you would like to share about your child?
Acknowledgement and Signature:
I, the undersigned parent/guardian, acknowledge that I have read and understood the above waiver and the following documents (emailed along with this document, and also available linked on the Sparkalicious website):

Sparkalicious Club Guidelines

Sparkalicious Health Policy

I understand that it is my responsibility to inform Julie of any changes to the information provided above.
Signature:
Date Signed:

MonthDayYear
Date
Should be Empty:

Sparkalicious Craft and Enrichment Club

Student Information:

Parent/Guardian Information:

Allergies and Special Needs:

Emergency Contact:

Consent and Liability Waiver:

Additional Information:

Acknowledgement and Signature: