Scholarship for Art Camp

Art Camp Scholarship Form

* Indicates required field

Name *

First

Last

Grade Entering in the Fall *

1st or 2nd 3rd or 4th 5th and up

Birthday *

T-Shirt *

Age *

You will choose your session at check out. Full sessions will be listed below.
FULL SESSIONS

We will do our best to give your child the size of your choice however T-shirts sizes are not guaranteed.

Second camper *

First

Last

Birth Date - 2nd Camper *

Age of 2nd Camper *

Grade Entering in the Fall for second camper *

1st or 2nd 3rd or 4th 5th and up

T-Shirt *

You will choose your session at check out. Full sessions will be listed below.
FULL SESSIONS

We will do our best to give your child the size of your choice however T-shirts sizes are not guaranteed.

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Email *

County of Residence *

2nd Phone Number *

Emergency Contact *

First

Last

2nd Emergency contact *

First

Last

Emergency Contact Number *

2nd Emergency Contact Number *

Relation to Child *

Child's Doctor *

First

Last

Phone Number *

Special Medical Needs: (to assist teachers, if registering 2 children indicate special instructions by child)

LIST ANY MEDICAL OR LEARNING PROBLEMS THAT WOULD EFFECT CAMP ACTIVITIES *

LIST ALLERGIES AND STEPS TO BE TAKEN IN CASE OF EXPOSURE *

DOES YOUR CHILD REQUIRE AN EPIPEN? IF YES, YOU NEED TO SEND ONE WITH YOUR CHILD EVERY DAY. *

MEDICATIONS/OTHER: *

IN THE EVENT THAT THE PARENT, GUARDIAN OR EMERGENCY CONTACT IS NOT AVAILABLE IN CASE OF EMERGENCY, I HEREBY GRANT THE QUINLAN VISUAL ARTS CENTER MY PERMISSION TO SECURE EMERGENCY MEDICAL TREATMENT FOR MY CHILD. *

Yes No

I HEREBY GIVE PERMISSION FOR MY CHILD/REN TO PARTICIPATE IN SUMMER ART CAMP AT THE QUINLAN VISUAL ARTS CENTER. I HEREBY RELEASE & HOLD HARMLESS THE QUINLAN VISUAL ARTS CENTER, IT’S STAFF, IT’S REPRESENTATIVES AND OR/AGENTS FROM ALL LIABILITIES AND ANY MISHAPS THAT MAY BEFALL MY CHILD/REN INCLUDING, BUT NOT LIMITED TO, THE ACTIVITIES IN THE CLASSROOM AND/OR OUTSIDE THE CENTER SUMMER ART CAMP FACILITY. *

Yes

Transportation: I understand that we the family, are responsible for arranging all transportation for my child/ren to and from the Quinlan Visual Arts Center camp sessions.

ALTERNATE PICK-UP PERSON *

First

Last

Phone Number *

ALTERNATE PICK-UP PERSON *

First

Last

Phone Number *

Media Release: I understand that staff photographers and/or television crews will at times be present to photograph or film the Quinlan Visual Arts Center classes, workshops, Summer Art Camp sessions and exhibitions. I hereby give my permission for resulting promotional photographs and television and/or television footage, which may include my child, to be used for promotional purposes on television, in newspapers, magazines, and press releases, on the arts center website or any other media deemed appropriate by the Board of Trustees of the Quinlan Visual Arts Center.

CLASSROOM POLICIES AND PAYMENT PROCEDURES (CPPP): BY CLICKING BELOW I ACKNOWLEDGE THAT I HAVE READ THE CPPP BELOW. *

I acknowledge the Quinlan policies

*Classroom Policies and Payment Procedures: Art Camp at the Quinlan Visual Arts Center is considered a class and therefore all Classroom Policies and Payment Procedures apply (click for detailed information). Art Camp is non-refundable. No deferred tuition payment system is available, nor may tuition be prorated. The Quinlan is not responsible for classes missed due to student absences. All instructors reserve the right to remove disruptive influences from their class. No refund will be given in the event of a dismissal. You may transfer your tuition to another session of Art Camp if notification of intent transfer is given FIVE FULL(5) business days before the first class, and if space is available. (A $15 transfer fee will apply.) If no space is available no refund will be given. You may give your canceled space to another student. Students may bring a friend to camp as long as the staff and teachers have been informed at least one day prior to arrival, as space is often limited. The day rate for Art Camp is $30 and all guests must have a completed Parental Consent and Medical Release form. If we have indicated a class is full and you register anyway you will be contacted to change your date or you will be issued a refund.

Camp scholarships will be under review of the Executive Director of the Quinlan Visual Arts Center. Please call 770-523-2575 or email [email protected] if you have any further questions about camp scholarships.

Submit

Quinlan Visual Arts Center

514 GREEN STREET N.E., GAINESVILLE GA 30501
770-536-2575

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