EMILY REYNOLDS ART
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Art Camp Registration Form
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Name
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Student's Email
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Student's Age
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Child's Phone Number
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Parent's/Guardian's Cell:
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Parent's Email
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Student's Address
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Emergency Contact Other than Parent:
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Student's Grade in School
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Does your child have any allergies, medications, or physical or emotional limitations we need to know about?
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Select Your Camp:
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Option 1: Architecture & Authors, ages 8-12 with Ms. Christa
Option 2: Celebrat. Around the World, ages 8-12 w/ Ms. Arielle
Option 3: Creative in Nature, ages 13-18, w/Ms. Emily
By registering my child (listed above) for half-day Art Camp 2025 (at the home of Matthew and Emily Reynolds in North Yarmouth, Maine) I hereby agree to legally assume all harm from risk my child may encounter. I consent that both my child and I are aware that some inherent risk may be present at camp, including (but not limited to) any of the following situations: permanent staining of clothing (if child forgets to bring and wear smock or apron), semi-permanent staining of fingers or skin with non-toxic paint, dyes, or inks, cuts, scrapes, or gouges from linocut tools and X-acto knives, burns from glue guns, bug bites, rashes from plants such as poison ivy, oak, or sumac containing urushiol oils while observing nature in wooded areas, allergic reactions to pollen on the Mèmak Trail and surrounding woodlands, etc. As legal guardian of registered said camper above, by typing my name below, I agree to refrain from sueing any of the instructors, their spouses, children, or relations due to any harm incurred while attending Summer Art Camp. I thereby agree DESPITE THESE RISKS, I AUTHORIZE MY CHILD(REN) TO PARTICIPATE IN ALL CAMP ACTIVITIES AND, ON BEHALF OF MYSELF, MY FAMILY, AND MY MINOR CHILD(REN), TO THE FULLEST EXTENT PERMITTED BY LAW, HEREBY WAIVE AND RELEASE ALL CLAIMS, DEMANDS, ACTIONS, CAUSES OF ACTION, COSTS, LOSSES, EXPENSES, MEDICAL BILLS, AND LIABILITIES OF ANY KIND OR NATURE (“CLAIMS”) INCLUDING BUT NOT LIMITED TO CLAIMS OF INJURIES, HARM OR LOSS ARISING FROM MY CHILD(REN)’S CAMP PARTICIPATION, CAMP ACTIVITIES, OR THE CAMP’S NEGLIGENCE, ACTION OR INACTION, WHICH MAY BE ASSERTED BY ANY OF US AGAINST THE CAMP, ITS STAFF, EMPLOYEES, AND AGENTS, AND I HEREBY AGREE TO INDEMNIFY, DEFEND AND HOLD THEM HARMLESS FROM ANY SUCH CLAIMS on the property of Matthew and Emily Reynolds on Steeple Chase Rd, North Yarmouth, Me, 04097, or on adjoining properties and trails, and neighbors' properties. Type full name below:
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Home
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Book Review
Oils Gallery
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About
Contact
Photography
Art Camp Registration Form