Art Camp Application

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APPLICATION DEADLINE for March 23rd Camp:

Feb 10th, 2024

Email *

Full Name *

Pronouns *

Age *

Address *

Email Address *

Phone Number *

Ethnicity *

Household Annual Income *

0-$25,000

$25,000 - $45,000

$45,000 - $65,000

$65,000 - $85,000

$85,000+

Number of members in your household

If under 18, name of parent/legal guardian *

Phone # of parent/legal guardian
*

Emergency contact name (if different than above)

Emergency contact phone # (if different than above)

Please answer the following questions:

Tell us about yourself! Why do you create art? How has art helped you? *

Why are you interested in Art Camp? *

Are you interested in art as a career? Why or why not? *

Why should you be chosen to attend the free Art Camp? *

Photo Release: Participant hereby consents to photographs, sound recordings, and all reproductions in any other manner (including video and audiotapes) of the likeness, voice and activities of the free workshop and further authorizes 11:11, its agents or assigns, to make unlimited use of such reproductions, including, but not limited to for advertising, publicizing, documenting, distributing, exhibiting, and broadcasting to the public over the radio, television, film, web, internet, social media or any other means, media, devices, processes and technology now or hereafter known.

I agree to the terms & conditions *

yes

Required

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