Please complete a form for each student.

Student Information
Fill out this form only AFTER you have purchased your class(es).
The Release Form must be filled out by the first day of class or we cannot accept the student in class. Only one release form per student is required, even if the student is enrolled in multiple classes.
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Registration
Please select the week(s) your child is registered.
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Demographics
The following information is used for grants and funding which supports the Summer Art Studios Program.
Is the child Hispanic or Latino?
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No matter what you selected above, please mark the appropriate selection(s) below to indicate what you consider the child’s race to be.
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Health Information
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In order to ensure the highest quality instruction for your student(s) and their classmates, we ask to be informed of any health issues your student may have. Southwest School of Art does not and will not discriminate against any student based on gender, race, national origin, ethnic origin, sex, age, religion, disability or any other status protected under federal, state or local laws.
Does your student receive special services or accommodations in school?
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Does your student have any current health problems?
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If yes, please tell us what kind of health problems.
Please use the text box below to include any additional information you think we need to know about your student (learning challenges, autism, allergies, etc) 500 character limit:
I understand that if my child requires medical treatment while participating in Summer Art Studios, an attempt will be made to notify me. In the event that I cannot be reached, I consent to such treatment for the child as may be deemed necessary under the circumstances, including but not limited to: X-ray examinations, surgery and anesthesia. I understand that I am responsible for all costs and expenses for such medical treatment.
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Medication
I give permission for my child to take PRESCRIPTION medication ordered by my child's physician while at SSA.
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When your student’s physician determines it is necessary to administer medication, the following procedures must be followed:
1. A parent/guardian or responsible adult designee will bring the medication to SSA
2. All medication must be in the original container clearly labeled with the student's name, the name and dose of medication, and directions for administration. Parents must provide all medications.
3. Only FDA approved pharmaceuticals manufactured in the United States will be administered. Homeopathic preparations will not be accepted.
4. Medications will not be sent home with students. All medication must be picked up by a parent/guardian or adult designee.
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Teens age 16 & above
My teen has permission to sign themselves out at the end of class. By releasing my teen, I understand they may leave the SSA campus and will release the SSA of liability for my student.
My teen has permission to sign themselves out at the end of class.
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Guardian Pick-up
I grant permission for my child to be picked up by the persons listed below:
I hereby release and hold harmless the Southwest School of Art, any officer, agent, contractor or volunteer from any and all injuries incurred by my child in connection with my child’s departure from the campus with a guardian.
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Photo Permission and Release
The Southwest School of Art captures images of Summer Art Studios activities for its archives and for use in publicity materials. I give permission to the Southwest School of Art, its staff and representatives, to photograph my child for such purposes.
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Submission
I release, acquit and discharge, and agree to indemnify and hold harmless, Southwest School of Art, its officers, directors, agents, employees, and contracted employees, against any claim, loss, liability, injury, damage, and expense loss or to property, which participants may, directly or indirectly, sustain or suffer as a result of my child’s participation in classes and use of Southwest School of Art grounds, equipment or gross negligence of Southwest School of Art.
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We have read and agree to uphold these guidelines for Summer Art Studios
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Once this form is returned to registration, you will have successfully registered your student(s) for Summer Art Studios at Southwest School of Art. You will receive a verification e-mail of your registration shortly.