Student Name *

First Name

Last Name

Is the student above the age of 18? *

If no, please provide us with the emergency contact information of a parent or guardian below.

Yes

No

Date of Birth

If the student is under the age of 18 please provide their birth date below.

MM

DD

YYYY

Parent / Guardian Name

First Name

Last Name

Phone

(###)

###

####

Hold Harmless Agreement *

The undersigned parent and or student agrees to hold harmless For the Love of Art, it’s officers, instructors, volunteers, agents and assigns from any and all liability for any damage or injuries arising from the party’s participation in art lessons, classes, workshops, art parties and any other related activities of any type provided by and/or at For the Love of Art, Art & Photography Studio.

I have read and agree to the above terms and conditions of this agreement.

Photography Release Waiver *

The undersigned parent and or student understands that photographs of participants and their artwork may appear in promotional materials both print and electronic without any reference to name as a result of his/her participation in classes, lessons, workshops, parties and related activities provided by/and or at For the Love of Art, Art & Photography Studio and agrees that all right, title and interest of same will be waived.

I allow For the Love of Art, Art & Photography Studio to use photographs of myself and my work.

I do not allow For the Love of Art, Art & Photography Studio to use photographs of myself and my work.

How did you hear about us? *

Internet

Facebook

Magazine / Newspaper Ad

Friend

Other