Participant Enrolment Form for Minors | The Dreaming Heart

top of page

Heart Art Logo_Wix_edited.jpg

The Dreaming Heart
Art Studio

Browse Art Prints on Etsy

HOME
ART CLASSES for YOUTH
PAINT NIGHTS for ADULTS
PRIVATE PAINT PARTIES for ADULTS
- Learn More!
- Canvas Gallery
PRIVATE PAINT PARTIES for YOUTH
- Learn More!
- Canvas Gallery
ART KITS
- Paint Night Kits
- Flower Yarn Painting Kits
ORIGINAL ART
TERMS & CONDITIONS
ABOUT
- Privacy Policy
- Contact
More...

Use tab to navigate through the menu items.

PARTICIPANT ENROLMENT FORM for MINORS

Please submit this form before your child's first art class with the Dreaming Heart Art Studio.

(An individual form must be completed for each child)

Please promptly resubmit the form anytime your child's information changes.

We require a parent/legal guardian to complete the following information.

Participant Information

CHILD'S FULL NAME*

DATE OF BIRTH (DD/MM/YYYY)*

Parent/Legal Guardian Information

FULL NAME OF PARENT/LEGAL GUARDIAN #1*

Relationship to the child*

Main Phone #*

Alternate phone #

Email address*

HOME ADDRESS (street address, city, province, postal code)*

FULL NAME OF PARENT/LEGAL GUARDIAN #2

Relationship to the child

Main Phone #

Alternate Phone #

Email address

Home Address (street address, city, province, postal code). *If different than parent/legal guardian #1.

Emergency Contact Information

FULL NAME OF EMERGENCY CONTACT(S) (other than parents/legal guardians)

Relationship to the child

Main Phone #

Alternate Phone #

Art Class Arrival & Departure

My child will:*

Be signed in and out by an authorized person

Arrive at and leave the Venue independently (must be 10+ yrs.)

Are the parent(s)/legal guardian(s) and emergency contact(s) listed above authorized to sign in and sign out your child?*

Yes

No

N/A, my child will be arriving at and leaving the Venue independently.

If you selected NO, please list the full name(s) of the parent(s)/legal guardian(s) and emergency contact(s) who ARE authorized to sign in and sign out your child.

Are there any ADDITIONAL persons (other than parents/legal guardians and emergency contacts listed above) who are authorized to sign in and sign out your child?*

Yes

No

N/A, my child will be arriving at and leaving the Venue independently.

If you selected YES, please list the full name(s) of the additional authorized person(s) below and their relationship to your child. *Please do not complete this section if your child will be arriving at and leaving the Venue independently.

If you have indicated that your child will be signed in and out by an authorized person, the authorized person must enter the Venue upon drop-off and pick-up to sign the attendance logbook.*

I understand

Allergy & Medical Information

Please list any allergies, medical conditions, or medications we should be aware of. If none, please write N/A.*

I understand that The Dreaming Heart Art Studio requires that all children who are prescribed an EpiPen, inhaler, and/or diabetic monitor carry their required medication/device(s) with them at all times while at the Venue. NO exceptions.*

Yes, I understand

I understand that The Dreaming Heart Art Studio does NOT guarantee an allergen-free environment. *

Yes, I understand

I assume all risk as it pertains to my child's allergies and medical conditions.*

Yes, I assume all risk

I understand that The Dreaming Heart Art Studio does not manage participants' medical conditions or administer medications or other medical treatments. *

Yes, I understand

I expressly grant The Dreaming Heart Art Studio consent to seek emergency medical care for my child when they are unable to contact me and when waiting for my consent would jeopardize the health and welfare of my child.*

Yes, I grant the Dreaming Heart Art Studio consent

Photo & Video Permission

The Dreaming Heart Art Studio may take photographs or videos of participants during classes or events for use in promoting the Studio, including on our website, social media, and other promotional materials.*

I give permission for my child to be photographed and recorded and for these images and videos to be used for promotional purposes.

I do not give permission for my child to be photographed or recorded.

Photo/video consent may be withdrawn at any time by contacting The Dreaming Heart Art Studio in writing via email at dreamingheartart@gmail.com.*

I understand

Additional Information

Is there any other information you would like to share with us about your child?

Parent/Legal Guardian Acknowledgment

Please review and agree to The Dreaming Heart Art Studio’s Terms & Conditions. Copy and paste this link into your browser: thedreamingheartartstudio.com/terms-and-conditions-art-classes, or access via the website menu> Terms and Conditions > Art Classes.*

I confirm that I have fully read and agree to the Dreaming Heart Art Studio's Terms & Conditions.

YOUR FULL NAME*

TODAY'S DATE*

By signing below, you confirm that you are the parent/legal guardian of the child(ren) listed above and that the information in this form is accurate and up to date. If any of the above information changes, please promptly resubmit this form.*

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

bottom of page