ACLC/WEST LINCOLN LIBRARY                                DIGITAL ART CLASS  REGISTRATION FORM
Help us make this the best camp experience you have ever had!  Please make sure to fill out all of the information completely.  We look forward to seeing you at camp!  Questions: 704-240-8466 or artslincolnnc@gmail.com 
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Name: *
First and Last
Address: *
Email: *
We prefer a frequently checked email address.
Phone: *
You may enter more than one phone number below.  Please specify mobile numbers.
Emergency Contact Name: *
Emergency Contact Phone: *
Age: *
Students must be between 7-18 years old. Adults do not have to answer.
Grade you will be entering (if a student): *
Which camps would you like to attend? *
Select all that apply.
Required
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.
Medical Info *
Does your child have any allergies or medical/physical conditions we should consider?  If so, please explain below.
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.
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