You may enter more than one phone number below. Please specify mobile numbers.
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Emergency Contact Name: *
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Emergency Contact Phone: *
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Age: *
Students must be between 7-18 years old. Adults do not have to answer.
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Grade you will be entering (if a student): *
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Which camps would you like to attend? *
Select all that apply.
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Liability Release *
By signing below, I am releasing Arts Council of Lincoln County (ACLC) and all employees and associates from responsibility of any injury or damages that might occur. I hereby authorize ACLC staff to act for me according to their judgment in any emergency requiring medical attention and I hereby waive and release ACLC and its employees from any and all liability stemming from any injuries or illnesses incurred while at camp.
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Medical Info *
Does your child have any allergies or medical/physical conditions we should consider? If so, please explain below.
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Photo Release *
I authorize ACLC to take photographs of my child/myself and their artwork for marketing purposes. I give permission for these pictures to be used in ACLC's printed materials, including advertisements, flyers, and website.