HOME
WHO WE ARE
About ArtReach
Our Team
Our Board
Annual Report
Testimonials
News + Updates
Join The Team
WHAT WE DO
In-School Programs
Artist Residency Programs
SPARK Programs
Rates + Funding
Title I Schools
Mural Programs
About Mural Programs
Completed Murals
Mural Artist Apprenticeship Program
Community Programs
About Community Programs
In-House Programs
Virtual Programs
ArtReach Learning Portal
Free Lessons
Portal Resources
Professional Development
Upcoming Events
SUPPORT
Donate
Shop Youth Art
Amazon Wish List
Funding + Community Partners
Partner with ArtReach
Fundraising Events
Barbara James Fund 2024
San Diego Gives 2024
Youth Art Show 2024
Charity Art Auctions
UPCOMING EVENTS
DONATE
ArtReach HQ Guardian Consent Waiver
PARENT/GUARDIAN INFORMATION
Parent/Guardian Name
(Required)
First
Last
Must match photo ID which will be verified at pickup.
Email Address
(Required)
Email Address
Confirm Email Address
Phone
(Required)
Relationship to Student(s)
(Required)
Address
(Required)
Street Address
Address Line 2
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Additional Parent(s)/Guardian(s) attending workshop?
(Required)
Yes
No
2nd Parent/Guardian Name
(Required)
First
Last
Must match photo ID which will be verified at pickup.
Phone
(Required)
Relationship to Student(s)
(Required)
3rd Parent/Guardian Name
First
Last
Must match photo ID which will be verified at pickup.
Phone
Relationship to Student(s)
EMERGENCY CONTACT INFORMATION
Emergency Contact Name
(Required)
First
Last
Must match photo ID which will be verified at pickup.
Phone
(Required)
Relationship to Student(s)
(Required)
STUDENT INFORMATION
Student Name
(Required)
First
Last
Age
(Required)
Birthdate
(Required)
MM slash DD slash YYYY
Add more Students?
(Required)
Yes
No
2nd Student Name
(Required)
First
Last
Age
(Required)
Birthdate
(Required)
MM slash DD slash YYYY
3rd Student Name
First
Last
Age
Birthdate
MM slash DD slash YYYY
4th Student Name
First
Last
Age
Birthdate
MM slash DD slash YYYY
5th Student Name
First
Last
Age
Birthdate
MM slash DD slash YYYY
GUARDIAN CONSENT, WAIVER OF LIABILITY, AND MEDIA RELEASE
As parent or legal guardian of the student(s), I agree to the following:
Engagement in Art Activities
(Required)
I confirm that the student is: able to participate and follow all directions and instructions by ArtReach Teaching Artists. I confirm that the student (ages 5+) is mature enough to attend a workshop without a legal guardian. I understand that if the student is unable to meet these expectations, I will attend the workshop with them. Disregarding studio rules and directions by ArtReach Teaching Artists and staff may result in immediate removal from the workshop. I understand that I am responsible for the transportation to and from the workshop for the student.
I agree to the above terms and conditions.
Risk Assumption
(Required)
I acknowledge the risks involved in participation in workshop activities and various visual arts materials and tools, and am permitting the student to attend and participate in ArtReach art workshops knowing these risks and potential consequences such as personal injury or loss of property. I understand that the studio space where the workshops are held will host other participants of all ages and that ArtReach is not responsible for any loss or damage of property to the student’s personal items. I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I and the participant(s) may be exposed to or infected by COVID-19 and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at ArtReach may result from the actions, omissions, or negligence of myself and others, including, but not limited to, ArtReach employees and other participants.
I agree to the above terms and conditions.
Liability Waiver and Release
(Required)
I hereby knowingly waive and release any and all known or unknown claim against ArtReach, its employees, board members, or other directly affiliated members, whether professionally or personally, including without limitation any actions, suits, procedures, costs, expenses, damages and liabilities, including attorney’s fees and costs, incurred due to claims brought by any third party as a result of or arising out of the participant’s involvement in activities and to reimburse ArtReach for any such costs, expenses and fees as they are incurred. Should any such claim, suit, cost, expense, or liability arise from the participant’s involvement in ArtReach programs, the undersigned shall defend, indemnify, and hold ArtReach harmless from any potential liability caused, related to, or arising from the participant’s involvement and/or conduct.
I agree to the above terms and conditions.
Media/Photo Release
(Required)
I permit ArtReach to use photos/videos of the student for potential promotional materials on social media, email campaigns, grant reports, and marketing collateral.
Yes
No
Parent/Guardian Certification
(Required)
I hereby certify that I am the parent or legal guardian of the above participant(s), and I have authority to waive rights on behalf of the minor participant(s). I have read and I understand all of the provisions of this document and the risks of activities.
I agree to the above terms and conditions.
Is there anything else you would like to share with us about your student(s)?
Subscribe
Name
First
Last
Email
×