Parent(s) name:

Name of child:

Age of child:

Email:

Phone:

Please select all:

I give permission for the articles, photographs and videos of my child at Kids Art Studio to be published and used for broadcast, reprint and electronic media purposes.
In case of emergency, I give permission to contact emergency medical services and arrange for transportation to the nearest emergency medical facility. If an emergency occurs, I will be readily available to pick up my child.
I hereby waive, release, absolve, indemnify, and agree to hold harmless Kids Art Studio, its instructor(s), organizers, sponsors, staff, participants and affiliates from and against all liability because of any bodily injury, or property damage, known or unknown, which may occur on result from participation of my child/ward in any and all activities.