Summer Camp 2022

Summer Camp 2022

Artist Information

Artist # 1*

First NameLast Name

Birth Date*

MonthDayYear

Shirt Size

Artist # 2

First NameLast Name

Birth Date

MonthDayYear

Shirt Size

Artist # 3

First NameLast Name

Birth Date

MonthDayYear

Shirt Size

Camps are located at One Church located at 7901 E. Sweetwater Rd, Scottsdale, AZ 85260. Camp prices include all fine art supplies, t-shirt, healthy snacks, individualized instruction, team building activities, outdoor play (weather permitting). Camps are open to ages 5 thru 12. Friday lunch is provided and an Art Show on Friday afternoon for family members to view for all artists between 2 and 3 p.m. We are looking forward to growing creativity together soon. BONUS 1: Half Day registrations now include camp for all day Friday at no extra charge! BONUS 2: Colorful JAC OF HEARTS T-shirt *Masks are optional at this time. In the event that AZ State or CDC requirements and regulations change due to Covid, Art Camps will transition to online. If you need additional assistance, please contact 480-646-6135. Thank-you. *

	All Day Camp 9am-3pm (M - F) $400	Half Day Mornings 9am_12pm $200	Half Day Afternoons 1-4pm $200	Drop-in Days (M-Th) $75	Early Bird 8-9am (M-F) $50	Working Bird 3-4pm (M-Th) $40
Week 2: June 27- July 1 Emoji's!
Week 4: July 11-15 Clayworks!_________

List any specific days or dates that you need for drop-in dates or exceptions.

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Parent/Guardian Information

Parent(s)

First NameLast Name

Best Contact Number

Area CodePhone Number

E-mail

example@example.com

Parent(s)

First NameLast Name

Best Contact Number

Area CodePhone Number

E-mail

Address*

Street Address

Street Address Line 2

CityState

Zip Code

Emergency Contact Information & Authorization Pick-up

Emergency Contact *

First NameLast Name

Phone Number

Area CodePhone Number

Relationship

Physician's Name and Phone #

Name of Insurance

Insured's Name

Group Name and/ or ID#

Preferred Hospital

Please list if your artist has any allergies (ie. including plants, food, and insect bites).

Please list any other medical information that may require special attention or consideration.

Medical Release and Authorization

In the event of a medical emergency, the undersigned parent(s)/ guardian(s), hereby grants authorization to JAC of HeArts, and its representative, to employ any legally licensed physician or health care facility on behalf of each of the undersigned, and to direct and/or order emergency medical treatment for the named participant(s). Each of the undersigned further agrees that neither JAC of HeArts nor any of its representatives shall be liable under any circumstances to anyone for exercising the foregoing authority in the event of the emergency.

I hereby give my permission for my child/ children to participate in all JAC of HeArts program activities. I, the undersigned, as parent or legal guardian of the minor child/ children listed on this application, hereby assume full responsibility for all risks of injury or loss which may result from my child’s participation in this activity and hereby agree to hold harmless, release, and discharge JAC of HeArts members or employees from and waive any and all claims and demands whatsoever which the undersigned and any third person of any accident, illness, injury or death of any person unless caused by the negligence of JAC of HeArts, employees, and/or agents.

I understand that it is my responsibility to inform JAC of HeArts staff if my child has a medical condition, allergy, physical, or other disability or condition that may require special attention. I agree to indicate such conditions on the Medical Release Form herein and discuss the situation in person with JAC of HeArts staff prior to attending camp.

Curriculum

I understand that the curriculum may include historical facts from artists, scientists, theologians, philosophers, scripture, music, prayer, song, writers, and more. References are made to illustrate how each person has a unique purpose and how to relate by making connections to each other thru visual arts. No reference is made to impose one’s viewpoint upon another, but to emphasize that all people are works of art and are uniquely and purposefully designed by God. Like people, artwork is unique and growing creativity is important in art creation, culture, self- expression, and problem solving. It takes teamwork to make the dreamwork!

Film and Photographic Public Release

I, the undersigned, as parent or legal guardian of the above named child/ children, authorize JAC of HeArts and its designated representatives to use any photographs and video recordings taken of said minor for any publicity and advertising purposes JAC of HeArts intends, without obligation or compensation to me. Safety is a high priority for this company. When it comes photos and film release, there is no disclosure of a child's full name or any identifying personal information.

A photo and film release permits group photos, individual photos, or videos to be taken of my child/ children by JAC of HeArts LLC. Such material may be used for weekly slide shows and/ or you tube videos. We respect your privacy and if there are exceptions, please elaborate in the field below after your initials.

I accept the film and photograph release policy.

Initials and request

Pick-up and Drop-off Procedures

Children must be signed in and out from class by an adult to ensure child safety. Ms. Contadino or an assitant will provide the sign-in sheet at the Faith Farm building located at the Northeast side of One Church. In the event you arrive after classes have started, you may reach the staff at (480)646-6135 to enter the classrooms.

Please be respectful of scheduled class start/ end times. Early Bird is available from 8-9am Monday thru Friday. Working Bird is available from 3-4pm on Thursdays with advance notice in consideration of scheduling.

*Masks are optional and safety precations are in place for utmost safety regarding according to mandated government guidelines at the camp location.

Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Full Name*

First NameLast Name

E-mail*

Payments due at the time of registration by cash, check, or charge to ensure your child's (children's) reservation. Please allow 24-48 hours to process your request. Enrollment is on a first come, first serve basis, and seating is limited. Please indicate your payment preference below.*

Please send me a Zelle payment request via email.I am paying cash/ check in person.Please send me a PayPal payment request via email.Other

Thank-you for your business! I look forward to growing creativity with your artistas soon! Be sure to watch from an email from Paypal invoice to confirm payment.

Kindly,

Ms. Julie Contadino