ArtMix Community Class Registration for Spring #2 2024 (April - May 2024) 
Please complete the form below to register for Community Arts Classes at ArtMix. The second spring session begins the week of April 1st and ends the week of May 16th. 

These classes will take place in person at ArtMix studios (1505 N. Delaware Street, Indianapolis, IN 46202).
Masks are currently optional and ArtMix is a judgement-free zone for people who need them for health reasons. Anyone experiencing COVID or Flu symptoms are asked to stay home from class until recovered. 

Class payment is due on the first day of class. You may also mail a check to ArtMix or call and pay via credit card in advance. Scholarships may be requested for anyone in need through this form. Please contact Sarah Jane with any questions or assistance with this form: sbryant@artmixindiana.org or (317) 974-4123.
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Email *
Student Contact Information
Student's First Name *
Student's Last Name *
Preferred name:
Age *
Date of Birth
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Pronouns (e.g. they/them, she/her, he/him)
Address *
City *
Zip *
Phone *
Email
Name of person completing this form:
Class Information
The second spring session begins the week of April 1st and ends the week of May 16th. 
 
Each class meets once a week on the day you select below. Please choose the class that works best for you and contact Sarah Jane with any questions or to chat about the best fit (sbryant@artmixindiana.org). You will receive a confirmation email when you submit this form.
Select that class you'd like to attend (limit 1 class per person): *
Student Health Information
List any allergies, special health needs, and accommodations (e.g. ASL interpreter, wheelchair access):
Disability (e.g. intellectual or developmental disability, visually impaired, on the autism spectrum, mental health disability, etc.):
Student is able to take care of basic needs (e.g. using the bathroom, taking medication, etc.) PLEASE NOTE: Unfortunately, ArtMix staff is not able to provide one-on-one assistance.
Clear selection
Student will be attending class with an aide/ assistant (including a parent). NOTE: Aides/assistants must also complete a registration form. No additional tuition is required for aides/assistants.  Registration form available here: Aide/assistant registration (will redirect to new page)
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Aide/ Assistant's name:
Emergency Contact *
Emergency Contact Phone *
Name/contact details for case manager (optional)
Student Demographics
Demographic information is optional and is used to help report back to funders who subsidize this program.
School Currently Attending
Do you qualify for free or reduced lunch?
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Do you receive social security benefits or wavier?
Clear selection
Student Ethnicity *
Student Gender *
Class Tuition
Tuition is on a sliding scale based on household income. All classes include supply costs. Please refer to the chart below to determine your fee. We never want cost to be a barrier, so scholarships are available for anyone in need.

Tuition is charged based on each session. For example, students who enroll on both Mondays and Tuesdays will pay tuition for each course.
Tuition Scale for Community Arts Classes
Enter your sliding scale tuition amount below:
Class Payment - Please select how you'd like to pay tuition this session. (Payments are not due until class starts. ) *
How did you find out about ArtMix Community Arts Classes?
I give permission to ArtMix to use photos of me, my child, and/or my artwork: *
Liability Release (signature required below)
In the event of an emergency or accident, ArtMix will, to the best of their ability, provide first aid and notify the parents or emergency contact via phone numbers provided on this form. I acknowledge that ArtMix staff are not licensed health care professionals. I waive and release all claims for liability that I may have against ArtMix, Inc., including all its directors, officers, employees, agents and instructors, for any injury, loss, or damage that may arise out of or in connection with ArtMix programs. I acknowledge that this waiver and release is given in return for, and in consideration of, ArtMix allowing me to participate in their programs.

By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) or I may be exposed to or infected by COVID-19 by attending in person ArtMix classes and curriculum 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 ArtMix may result from the actions, omissions, or negligence of myself and others, including, but not limited to, ArtMix employees, volunteers, and program participants and their families. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my child(ren) may experience or incur in connection with my child(ren)’s attendance at ArtMix or participation in ArtMix programming (“Claims”). On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless ArtMix, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of the ArtMix, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any ArtMix program.
Insert signature (Parent/guardian if under 18 or under guardianship): *
A copy of your responses will be emailed to the address you provided.
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