KAC Adult (18+ yrs) Emergency Form
Thank you for enrolling in a Krasl Art Center (KAC) program! Please fill out this Emergency Form before the first day of class.

Please answer all questions to the best of your ability.

If you have any questions or concerns, please reach out to Director of Education, Nathan Margoni, at nmargoni@krasl.org
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Email *
Student Name (First & Last) *
Student Phone Number (If Applicable)
Student Pronouns (he/she/they/other) - https://www.mypronouns.org/
Emergency Contact Name(s) and Phone Number(s) *
We pay close attention to each student's social/emotional and general needs. Do you have any allergies, medicals needs, or anything else we need to know? Please describe:
Emergency Treatment Release: In the event of a serious illness, accident, or injury that would require medical attention, 911 will be called and the student may be taken to the nearest emergency center. If necessary, an Emergency Medical Staff or a First Aid/CPR trained KAC Staff Person will take care of the student. *
Required
Photo Release: I give permission to be photographed for use by Krasl Art Center (KAC). I grant KAC the right to use the photograph for the purpose of promotional advertising & documentation. Any questions or concerns may be sent to marketing@krasl.org. *
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