Registration Form - Cuddles learning, Pixel Art Creative Workshop

Registration Form - Cuddles learning, Pixel Art Creative Workshop
ABOUT THE PROGRAM
In partnership with North York Arts, Cuddles Learning is running a creative Pixel Art Workshop at Grandravine Community Recreation Centre. Through this hands-on activity, children will explore how pictures are built using simple grids while developing creativity, focus, and problem solving skills.

Cuddles Learning is a Canadian education company offering STEAM-focused classes and workshops for kids aged 6–12, both online and in-person.

in this intro to pixel art workshop participants will learn skills that can redefine the way people see art and technology
This application will take around 10 min to be filled out. If you request support to fill out this form please contact programs@northyorkarts.org or call +1 647-477-6059 and leave a voice message for "Declan".
This program is for children aged 6-12, are you eligible for this program?
CONTACT INFORMATION
Name

First NameLast Name
Preferred Name
Date of Birth

MonthDayYear
Date
Pronouns:

Other
Date of birth

DayMonthYear
Date
Postal Code
Area you live in:

Other
Please note that if spots are limited priority will be given to North York residents.
Personal Email
example@example.com
Phone number
Please provide the best number for NYA staff to reach youFormat: (000) 000-0000.
Parent/Guardian Name

First NameLast Name
Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Email
example@example.com
Emergency Contact
Emergency Contact Name

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
PROGRAM QUESTIONS
Select a Date (one per participant)
Why are you interested in this program?
Please tell us if you have specific needs in order to participate in this program:
OUTREACH QUESTIONS
How did you hear about the program?

Other
Did you know about North York Arts before this program?
SECTION 5: DATA COLLECTION
Why are we collecting this data? North York Arts is strongly committed to equity and inclusion in our programs. With this in mind, we have set out specific programming goals in our strategic plan to better serve our communities. To ensure that we do so, we are collecting data on how our participants self-identify. This is completely optional but we appreciate your input, if you prefer not to disclose chose the option Prefer not to disclose.
Gender Identity (select all that apply)

Other
How to do you identify your ethnicity and race? (select all that apply).

Other
Are you a Newcomer, Refugee, or Immigrant to Canada? (select all that apply)

Other
What is your first language?
Do you identify as a person part of the 2SLGBTQ+ community?
Do you identify as part of the Deaf and Disabled community?
PHOTO RELEASE AND SOCIAL MEDIA CONSENT FORM
At North York Arts, part of our marketing strategy involves creating an online presence through content generation on our website and social media channels, as well as producing other forms of marketing materials.

We are respectful of the privacy of our employees and the public at large. Therefore we wish to obtain your express consent to produce images, videos of you, or testimonials from you for marketing purposes.
Using the boxes below, please indicate your consent for the organization to use photos, videos or testimonials of you in marketing materials, such as those listed above.

I consent to having images or videos of me and/or testimonials related to North York Arts be used for marketing purposes such as presentations, promotions, or other similar manners of publication. I understand that the material provided by me may be condensed, edited or summarized as needed by North York Arts. My consent is freely given to North York Arts as a public service, and I am aware that I will not be compensated for the use of the photograph(s), image(s), and/or testimonials. I hereby release North York Arts, its officers, employees, and agents from any and all claims for harm or liability arising from any distortion, blurring, or alteration, optical illusion, or use in composite form, whether intentional or unintentional. I understand that I have the right to revoke this authorization at any time by writing to North York Arts. Any actions taken prior to receipt of this written notification will be unaffected by the revocation.
Date

MonthDayYear
Date
Personal Information and Privacy Act (PIPA) Statement

We collect only the personal information that we need for the purposes of providing services to our clients. We protect personal information in a manner appropriate for the sensitivity of the information. We make every reasonable effort to prevent any loss, misuse, disclosure or modification of personal information, as well as any unauthorized access to personal information
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Registration Form - Cuddles learning, Pixel Art Creative Workshop

ABOUT THE PROGRAM

CONTACT INFORMATION

Emergency Contact

PROGRAM QUESTIONS

OUTREACH QUESTIONS

SECTION 5: DATA COLLECTION

PHOTO RELEASE AND SOCIAL MEDIA CONSENT FORM