Itsy Arts Fall 2022 Registration - Illinois Art Station

Itsy Arts at Illinois Art Station is art exploration for our youngest artists ages 2-5!

Cost: $12 per participant per class

When: Mondays: September 16, October 14, November 11, & December 9 from 10:00 – 11:00 a.m.

Where: Illinois Art Station (101 E. Vernon Avenue, Normal, IL)

Parents or guardians must attend Itsy classes with their child(ren).

Registration for Itsy Arts is limited to (15) young artists per class.

NOTE: A complete registration form must be submitted for each young artist participating in Itsy Arts Fall 2024.

Questions? Contact joey.hatch@illinoisartstation.org or info@illinoisartstation.org

Young Artist Full Name*

First NameLast Name

Young Artist Preferred Name (if different from above)

Age of Young Artist (2-5yo)*

Pronouns of Young Artist*

She/HerHe/HimThey/ThemOther

Address of Young Artist*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Indicate the sessions of Itsy Arts you are registering for*

Monday, September 16 (10:00-11:00)Monday, October 14 (10:00-11:00)Monday, November 11 (10:00-11:00)Monday, December 9 (10:00-11:00)

Photo Release: I authorize that any photo/video taken of my child during this program at Illinois Art Station (IAS) may be used in IAS publications, and/or published on the IAS website and/or social media profiles, as well as used in similar applications by IAS partner organizations within the context of promoting IAS and its programs.*

YesNo

Art Materials Release: Art making is often MESSY—in a good way! IAS makes every effort to use safe, non-toxic, and washable materials (when possible). But, we ask that you remind your child(ren) to wear clothes that can be washed. Illinois Art Station is not responsible for any damages incurred through your child(ren)'s use of the art making materials provided.*

I have read and agree to the statement above

Risk Release: On behalf of myself and the named minor (young artist), I hereby certify that I have full knowledge of the nature and extent of the risks inherent in participation in classes, camps, and programs at Illinois Art Station. And that I, on behalf of myself and the named minor, am voluntarily assuming said risks. I understand that I and the named minor will be solely responsible for any loss or damage, including personal injury, property damage, or death, the named minor sustains while participating in IAS classes, camps, and programs, and that by accepting this agreement I hereby, on behalf of myself and the named minor, release the officers, agents, and employees of the Illinois Art Station and any contributing partners of all liability for such loss, damage, or death. I further certify that the named minor is in good health and has no conditions or impairments that would preclude their safe participation in classes, camps, and programs at Illinois Art Station.*

I have read and agree to the statement above

Allergies & Medical Needs*

List any allergies, medications, or other needs that IAS staff/instructors should be aware of

What is one thing we should know about your young artist? What is one thing that your young artist wants us to know about them?*

If your young artist is multi-lingual / language diverse and would benefit from additional language assistance, please elaborate below.

We believe that ART is a universal language than can transcend communication barriers. Illinois Art Station can only consistently offer art education instruction in English at this present time, but we want to anticipate and meet the needs of our young artists as we can. Thank you for your transparency and understanding!

Primary Guardian Full Name*

First NameLast Name

Pronouns of Guardian

She/HerHe/HimThey/ThemOther

Primary Guardian Email*

This email address will be the primary means of communication regarding any info or updates about the class or your student artist.

Primary Guardian Phone #*

This is the number that IAS staff/instructors will call first should they need to communicate information about your student artist.

Primary Guardian Phone*

CellHomeWork

Alternative Phone #*

Should IAS be unable to contact the Primary Guardian phone number, IAS staff will call this number.

How did you hear about classes at Illinois Art Station? Click all that apply.*

Has your young artist participated in IAS classes/camps/programs before?*

YesNo

Price & Payment, PLEASE READ IN FULL:

Illinois Art Station is committed to ensuring that young artists and families from all neighborhoods and backgrounds have access to transformative experiences in the visual arts regardless of their ability to pay. To achieve this access, IAS offers a pay-what-you-can model for class registration. We know that IAS families who are able to financially support the Illinois Art Station and our programs will do so happily. We also know that our IAS families who require assistance will benefit greatly from a flexible pricing structure. Your tuition—no matter the total—will help cover the costs of expert planning/facilitation, materials, site maintenance, and everything else that makes IAS programming so great. AND, any additional funds will help sponsor the cost of hands-on art engagement for young artists and families who require reduced or free tuition. Thank you in advance for your support and helping make art accessible to all who are drawn to it (pun intended)!

The full price of 1-4 sessions of Itsy Arts is $12, $24, $36, & $48 respectively.

Any payment higher than the recommended totals will be considered a donation toward supporting current and future IAS programs. Any payment less than the recommended totals (as low as $0) will still allow for your young artist’s participation in the program. Families with an annual household income less than $36,000 or who qualify for free/reduced lunch should feel welcome to pay less than the recommended amount.

Itsy Arts Fall 2024 Payment*

Itsy Arts FULL PRICE

$12.00 Itsy Arts FULL PRICE

Itsy Arts PAY-WHAT-YOU-CAN Product Image

Itsy Arts PAY-WHAT-YOU-CANUse the drop down menu to select your total payment for 1-4 sections in increments of $5

$5.00 Quantity

Itsy Arts FULL SCHOLARSHIP Product Image

Itsy Arts FULL SCHOLARSHIPThis option is reserved for any artist/family whose annual household income is less than $36,000, whose household qualifies for the federal free/reduced lunch program, or whose current financial circumstance for any reason would benefit greatly from $0 cost.

$ Free

Itsy Arts Additional Donation Product Image

Itsy Arts Additional DonationAny payment higher than the recommended FULL PRICE will be considered a donation to supporting current and future IAS programs. Use the dropdown menu to select your total donation in increments of $5.

$5.00 Quantity

GIFT CARD Payment: Itsy Arts Product Image

GIFT CARD Payment: Itsy ArtsCopy/paste the link below in your browser to complete payment using an IAS GIFT CARD. Choose Itsy Arts and proceed with check out according to the quantity registered. Include the name of your young artist in the "Note to seller" section. Do NOT forget to submit this form to complete your registration. https://illinois-art-station-giftcard.square.site/

$ Free Quantity

Total

$0.00

Credit Card

ITSY ARTS FALL 2024 REGISTRATION

Credit Card