Community Class Aide/Assistant Registration Spring #2 2024 (April- May 2024)
Occasionally, student, students are accompanied by an aide, assistant, parent, or therapist.
We do not charge tuition for people who accompany a student, and you are welcome to participate in classes.
Limit - one aide per person due to class limited times. 

We do require a separate registration for in order to explain policies and ensure enough seats in the studio.
Our policies are as follows:
-It is required for you to be near the student at all times. You may sit in the waiting area, if best for the student; however, you are to always be available for the student, should you be needed.
-If a student needs to leave the class for safety reasons, please make sure to stay with the student. 
-You must remain in the building during class time.
-If you need to leave for any reason, you must tell the ArtMix staff in charge.
-You may leave the classroom with the student, if a break is needed.
-Please do not use cell phones in the classroom, unless for taking pictures of artwork.

 Please contact Sarah Jane with any questions sbryant@artmixindiana.org or (317) 974-4123.
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Email *
First Name *
Last Name *
Pronouns (e.g. she/her, he/him, they/them)
Full name of student being assisted *
Day of the week that student is attending: *
Email *
Phone *
Your emergency contact and phone number: *
Do you work for a service-providing agency?
Clear selection
If yes, supervisor's name:
Supervisor's telephone number or email:
Have you been given training to work with this student?
Clear selection
If not with an agency, what is your relationship to the student (family, friend, etc.)
Does this student need "hand-over-hand" assistance? *
Does this student need assistance with personal care?
Clear selection
Will you plan to be in the classroom with the student? *
I give permission to ArtMix to use photos of me and/or my artwork: *
Safety and Policy Information
Aide/Assistant Policy:
-It is required for you to be near the student at all times. You may sit in the waiting area, if best for the student; however, you are to always be available for the student, should you be needed.
-You must remain in the building during class time.
-If you need to leave for any reason, you must tell the ArtMix staff in charge.
-You may leave the classroom with the student, if a break is needed.
-Please do not use cell phones in the classroom, unless for taking pictures of artwork.

By signing digitally below, I acknowledge I have read and agree to adhere to the ArtMix policy.

COVID-19 Policy:
ArtMix will take every precaution to provide for the protection and safety of all participants. In the event of an emergency or accident, ArtMix will, to the best of our ability, provide first aid and notify the parents or emergency contact via phone numbers provided on this form. By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) or I may be exposed to or infected by COVID-19 by attending in person ArtMix classes and curriculum and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at ArtMix may result from the actions, omissions, or negligence of myself and others, including, but not limited to, ArtMix employees, volunteers, and program participants and their families. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my child(ren) may experience or incur in connection with my child(ren)’s attendance at ArtMix or participation in ArtMix programming (“Claims”). On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless ArtMix, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of the ArtMix, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any ArtMix program.
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