Please fill out the following form if your child is attending the Dreaming Heart Art Studio for the first time, or you would like to provide updated information for a previously submitted form.

New Student Intake Form

This form must be filled out and submitted by the parent/legal guardian of the minor child who will be attending the Dreaming Heart Art Studio.

CHILD'S INFORMATION

PARENT/LEGAL GUARDIAN INFORMATION

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EMERGENCY CONTACT INFORMATION

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ALLERGIES & MEDICAL CONDITIONS

PHOTO & VIDEO CONSENT

I hereby give my consent to the Dreaming Heart Art Studio to take and use photographs and videos of my child for any legal use including but not limited to advertising and publicity purposes, as follows: printed publications or materials, posters, brochures, electronic publications, and social media. I hereby waive, release, and forever discharge the Dreaming Heart Art Studio from any and all claims or liability arising from the use of my child’s photograph or video for the above purposes. This authorization is continuous and may only be withdrawn by my specific rescission of this authorization. Furthermore, I understand that no royalty, fee, nor other compensation shall become payable to me by reason of such use.