KAC 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 fill out a separate form for each attending student.

If you have any questions or concerns, please reach out to School & Community Programs Coordinator, Emily McKenna, at emckenna@krasl.org
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Email *
Student Name *
Student Pronouns - https://www.mypronouns.org/
Guardian Name (If under 18 years of age)
Adult Student / Guardian Phone Number *
Emergency Contact Name (For Adult Students) *
Emergency Contact Phone Number (For Adult Students) *
I give permission to the following people to pick up my student from KAC. For each individual, please include full name & phone number. PLEASE NOTE: Any individual picking up or dropping off a student is required to have Photo ID available upon request.
Do you, or your student, have any allergies or other medicals needs? Please describe: *
We pay close attention to each student's social/emotional and general needs. Is there anything else that would be helpful for us to know? *
Emergency Treatment Release: In the event of a serious illness, accident, or injury that would require medical attention, 911 will be called and my child 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 my child.
Medication Dispense Release: I authorize KAC's Education Administrative Staff to hold and dispense medication to my student.
Text Message Alerts: Check this box to receive text notifications from Krasl Art Center regarding emergencies, closures, delays, and reminders. You may receive up to three messages per month. Messages and data rates may apply. Reply STOP to end or HELP for help.
Sign-In & Sign-Out Signature Release: Guardians are required to sign in and out of class for students age 13 and under, unless there are special circumstances.  Please explain special circumstances in "other" if necessary. *
Required
Photo Release: I give permission for myself, or my student, 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.
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By selecting "I Agree" below, that indicates that I have read and understand the policies stated above and I agree to abide by them. *
Required
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