ArtSprout GSO Registration for 2025 Summer Camp
Camp Details

Session Dates: July 14th - 18th & July 21nd - 25th 2025
  
Time: 8am - 3:30 pm 
Location: Prince of Peace 1100 Curtis St., Greensboro NC, 27406
Cost: $65 per week ($120 for both weeks)
Sign in to Google to save your progress. Learn more
Clear selection
Participant Information  *
First and Last Name
Guardians Name and Number: *
Do you live in Warnesville community or Hampton Homes Apartments and need transportation? If you so,  list your address below.
Grade Level *
Required
Age: *
Participant Pronouns: *
Emergency Contact - Name and Number and Relation *
Email *
Medical Information: *
Any allergies or dietary restriction?
Medical conditions?
Current medicines?

If NONE apply to your child, answer "NONE".
Artistic Experience - Level of artistic experience
Clear selection
Preferred Art Mediums:
Photo Release: *

Dear Parent/Guardian:

During the camp year, we take photographs of camp activities involving students to share ArtSprout's positive vibe and updates. By which incidentally, some photographs may capture your child's participation, directly or indirectly.

These photos may be published through our website, social media pages, news bulletins, billboards, and ads.

With this, we seek for your consent in allowing us to publish photos which may involve your child to the said platforms.

Please do provide your response by selecting your choice below and submitting this form:

Medical Treatment Consent: *
**Medical Treatment Consent Form** 

I, [Participant's Full Name], or as the parent/legal guardian of [Participant's Full Name if a minor], hereby authorize the staff and organizers of the art summer camp to obtain medical treatment for the participant in case of an emergency or if it is deemed necessary for the participant's well-being.

In the event of an emergency, I can be reached at the following contact number: [Emergency Contact Number Provided Above]. If I cannot be reached, I authorize the camp organizers to act on my behalf to obtain necessary medical treatment for the participant. 

I understand that every effort will be made to contact me in case of a medical emergency. However, in situations where immediate action is required, I authorize the camp staff to seek medical attention, including but not limited to administering first aid, contacting emergency medical services, and transporting the participant to a medical facility (Moses Cone Hospital). 

I also confirm that the information provided regarding the participant's medical history, allergies, and current medications is accurate to the best of my knowledge. 

Signature: __________________________ Date: ________________ (Parent/Guardian if the participant is a minor)

Typing your First and Last name and date will be held as a signature.
Special Request:
Accommodations needed or additional comments or request.
Liability Waiver: *


**Liability Waiver, Acknowledgment of Risk, and Release of Liability**

 I, [Participant's Full Name], or as the parent/legal guardian of [Participant's Full Name if a minor], hereby acknowledge and understand that participation in the art camp involves inherent risks, including but not limited to physical injury, illness, or property damage. I voluntarily accept and assume all such risks for myself or on behalf of the participant. 

In consideration of being allowed to participate in the art camp, I hereby release, discharge, and hold harmless [ArtSprout Art Camp Organizer/Organization], its employees, agents, and representatives from any and all claims, liabilities, demands, expenses, or causes of action arising out of or related to any loss, damage, or injury, including death, that may be sustained by the participant during their involvement in the art camp. 

I understand that [ArtSprout Art Camp Organizer/Organization] will take reasonable precautions to ensure the safety and well-being of participants. However, I acknowledge that accidents and unforeseen events may occur. I agree to indemnify and hold [Art Camp Organizer/Organization] harmless from any claims or suits arising out of or in connection with the participant's participation in the art camp. 

I further acknowledge that this waiver and release of liability is binding upon myself, the participant, and our respective heirs, executors, administrators, and assigns. I have read and fully understand the terms of this Liability Waiver, Acknowledgment of Risk, and Release of Liability. 

Signature: __________________________ Date: ________________ (Parent/Guardian if the participant is a minor)

 Typing your First and Last name and date will be held as a signature.

Code of Conduct: *

** ArtSprout Art Program Summer Camp Code of Conduct** 

**Behavioral Expectations:** 

1. **Respect:** - Treat fellow participants, staff, and instructors with kindness and consideration. - Respect personal space and belongings of others. 

2. **Safety:** - Follow safety guidelines and instructions provided by camp staff. - Use art supplies and tools responsibly and as directed. 

3. **Participation:** - Engage actively in art activities and group sessions. - Contribute positively to the collaborative and creative atmosphere of the camp. 

4. **Listening:** - Listen attentively to instructions from camp staff and instructors. - Be respectful when others are speaking or presenting. 

5. **Inclusivity:** - Embrace diversity and be inclusive of all camp participants. - Avoid discriminatory or disrespectful language and behavior. 


**Consequences for Violations:** 

1. **Verbal Warning:** - A verbal reminder of the camp's expectations and a chance to correct behavior. 

2. **Time Out:** - Temporary removal from the current activity to reflect on behavior. 

3. **Parent/Guardian Meeting:** - In the case of repeated violations, a meeting with the parent/guardian to discuss the situation and find a resolution. 

4. **Probation:** - A written notice outlining specific behaviors that need improvement, with a probationary period. 

5. **Dismissal:** - In severe cases, dismissal from the camp without a refund. It is understood that the consequences will be applied based on the severity and repetition of the behavior. 

The goal is to create a positive and inclusive environment that fosters creativity and mutual respect among all participants. 

I have read and agree to abide by the ArtSprout Art Program Summer Camp Code of Conduct. 

Signature: __________________________ Date: ________________ (Parent/Guardian if the participant is a minor)

Typing your name and date is agreeing to the terms above. Please review these with the participate.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms