Are you a new or returning customer for camp or classes at Unicoi Art Studio?
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New
Returning
If you are a returning customer skip down to student information
Mothers full name
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Mothers mobile phone
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Fathers full name
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Fathers mobile phone
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Emergency contact's name
(optional)
Emergency's contact phone
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E-mail
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May we e-mail you our newsletter with session info, special events and promotions?
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Yes
No
How did you here about our camp?
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Unicoi Art Studio or website
Online search
A friend
Lives in the neighborhood
Pearachute
Other
Student 1
Student 1 Name
Student 1 Age and Date of Birth
Student 1 School
What allergies or health conditions should we be aware of for this child?
Student 1: Select camp days and times
Parent Teacher Conference- April 18
(optional)
Please select
1:30-4:00 AFTERNOON CAMP $40.00
Student 2
Student 2 Name
(optional)
Student 2 Age and Date of Birth
(optional)
Student 2 School
(optional)
What allergies or health conditions should we be aware of for this child?
(optional)
Student 2: Select camp days and times
Parent Teacher Conference- April 18
(optional)
Please select
1:30-4:00 AFTERNOON CAMP $40.00
Sibling discounts, late fees, and adding additional camp
SIBLING DISCOUNTS: If you register 2 or more siblings at the time of purchase, you will receive 5% off your complete order. Checkmark sibling discount below. Discount only valid on orders completed with 2 or more siblings at the time of that purchase. If you purchase classes for 1 student and then add another later, you can get the discount on the second order, but completed orders cannot be changed. Not valid with equal to or greater discounts or promotions.
SIBLING DISCOUNT- I am enrolling more than 1 sibling today (5% off)
(optional)
LATE FEE- I am registering late (after 3pm, the day before I attend camp) How many students are you registering late?
ADD MORNING CAMP- I have paid for afternoon camp and now want to attend the whole day
ADD AFTERNOON CAMP- I have paid for morning camp and now want to attend the whole day
Waivers and Policies
I acknowledge and understand that Unicoi has a NO NUT product requirement for all Participants. Please do not bring nut products to class or camp. If my child does have a nut allergy, I do hereby authorize and allow Unicoi Art Studio, LLC, all of its employees, officers, members, managers, agents and other affiliated persons or entities (“Unicoi”) to administer emergency anaphylactic shock medication to Participant for the purpose of alleviating the symptoms of an allergic reaction. I, for other good and valuable consideration, hereby fully and forever waive, relinquish, release and discharge Unicoi and all of its employees, officers, members, managers, agents and other affiliated persons or entities, from any and all claims, demands, and causes of action this emergency allergic reaction medication administration form and waiver. I agree not to sue Unicoi or any of its employees, officers, members, managers, agents or other affiliated persons or entities as a result of any claim, injury or event that may occur as a result of this agreement. I have provided Unicoi with the emergency medication that my child, Participant, requires in the event of anaphylactic shock. I have provided this emergency medication to Unicoi and have advised Unicoi on the medication’s use and administration according to the terms of the medication’s instructions and disclaimers.
ABSENCE | MAKE-UP POLICIES
You must schedule your drop-in dates by 3pm the DAY BEFORE YOU WOULD LIKE TO ATTEND OR EARLIER, to avoid a $10 late fee. Please add the late fee at the bottom of this form for any students added after 3pm the day before you plan to attend, including adding afternoons and mornings.
CANCELLATION POLICIES:
In the event of a medical emergency involving my child, I hereby authorize Unicoi Art Studio to act in loco parentis to my child. The studio may authorize all necessary medical and/or surgical procedures that are deemed vital for the health of my child. I understand that every effort will be made to contact me immediately and that medical or surgical procedures will be implemented only in the event that I cannot be contacted. I understand and will comply with all registration, tuition and cancellation policies, rules and procedures and have read and agree to accept the above obligations and responsibilities of all programs at Unicoi Art Studio.
I also acknowledge that Unicoi may periodically photograph or video its participants and their artwork and I grant my full permission for Unicoi to photograph, video, record, or reproduce images of my child and their artwork. I consent to Unicoi’s use of these recordings and agree to relinquish any claims to royalties or damages. I acknowledge and understand that Unicoi has a no nut product requirement for all Participants and their families. This means that I promise not to provide my child with any food items containing nuts, nut by-products, or made in contact with nuts for consumption at Unicoi or
on any Unicoi function. I understand that many children have peanut and other nut allergies and that sending my child with nut-containing products may cause allergic reactions in other participants. If my child has a nut allergy, I understand that it is impossible to eliminate all nut contact. I hereby waive any and all claims against Unicoi for any exposure, intentional and/or negligent, my child may encounter to nut, nut by-product, or product made in contact with nuts.
