2025 Spring Break Art Camp

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Event Timing: March 10, 2024 to March 13, 2024
Event Address: Art Cellar Houston, 1809 Eldridge Parkway, Suite 210, Houston, Texas 77077
Contact us at (832) 596-7983 or Email artcellarhouston@gmail.com

Email *

Child 1 Name & Age *

Child 2 Name & Age: *

In Case of Emergency Contact Name & Phone *

Alternate 1 Pick Up Name & Phone *

Alternate 2 Pick Up Name & Phone *

Allergies:

My child has allergies to the following foods, nuts, herbs, and/or spices. Please choose "None" if your child does not have any food allergies or list the items your child is allergic too under "Other".

None

Nuts

Vegan

Herbs

Gluten-free

Spices

Other:

Required

Assumption of Risk, Release of Liability, and Indemnification Agreement

The Art Cellar of Houston and staff are not certified or liable for any child with special needs. PLEASE READ our liability statements carefully, and sign prior to registering your child for our art camps.

I, [Parent or Legal Guardian Name], hereby acknowledge and agree to the following terms and conditions by selecting each box below. I understand and accept that my child will not be permitted to attend the summer program unless all boxes are checked:

I understand it is my responsibility to advise the Art Cellar Houston Staff of any medical conditions, allergies, or any circumstance that would inhibit the Art Cellar Houston staff from teaching the class and the student participation in the above-mentioned art program.

I verify and affirm that my child has no medical condition that would prevent their participation in this program, nor will they verbally or physically threaten any child or any member of our teaching team at our studios.

I understand paint is toxic and will stain clothes, and therefore (on behalf of my child) agree to explain to my child not to consume the paint or put it on their clothing and/or body.

I agree to assume full responsibility for any risks, injuries, or damages known or unknown that my child may inflict or incur as a result of participating in this art camp at The Art Cellar of Houston LLC. Any child inflicting threats and/or harm on any child and/or teacher will be removed from our program without refund. No exceptions.

I knowingly, voluntarily, and expressly waive any claim I may have against The Art Cellar of Houston, Sarah B. Lowe, and any other instructor imparting classes at the Art Cellar of Houston for the Spring Break Art Camp from March 10th to 13th 2024 for any injury or damages sustained as a result of participating in this program. I, my heirs, or representatives forever release, waive, discharge, and covenant not to sue Sarah B. Lowe and any other instructor imparting classes at the Art Cellar of Houston for any injury or death caused by negligence or other acts. I have read the above waiver and release of liability and fully understand its content. I voluntarily agree to the terms and conditions outlined above.

Required

Photo Consent:

We recognize the need to ensure the welfare and safety of all young people taking part in any activity associated with our organization. In accordance with our child protection policy, we will not permit photographs, videos, or other images of young people to be taken without the consent of the parents/carers and children. As your child will be taking part in the event specified above, we would like to ask for your consent to take photographs/ videos of the event or activity that may contain images of your child. It is likely that these images may be used as

• a record of the activity or the event.

• in a written evaluation of the event that will be viewed by the public.

• publicity material for further activities or events on leaflets/websites/ magazines.

• illustrations of the activities or events in published articles, artcellarhouston.com, or the company’s social media sites.

• future grant applications.

We will take all steps to ensure these images are used solely for the purposes they are intended. If you become aware that these images are being used inappropriately you should inform us immediately.

Please check the appropriate box below.

I consent to have my child photographed or recorded and posted on the Art Cellar of Houston’s social media and/or website pages.

I DO NOT consent to have my child photographed or recorded and posted on social media and/or the Art Cellar of Houston website.

The participant attending our art camp is not 18 years of age or older. I provide consent as the parent or guardian for the participant. I have read, understood, and agree to the above outlined terms.

Parent or Guardian, please electronically sign below to assume responsibility for the above terms.

A copy of your responses will be emailed to the address you provided.

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