PD Day Art Camps 2021-22

September 24, 2021 - Sold Out October 22, 2021 - Sold Out November 19, 2021 - Sold Out November 25, 2021 - Sold Out February 18, 2022 - $46.00 CAD March 23, 2022 - $46.00 CAD April 7, 2022 - Sold Out

Participant 1 Name: First & Last Name

Participant 1: Pronoun

Participant 1: Date of Birth (YYYY/MM/DD)

Participant 2 Name: First & Last Name

Use NA if not applicable.

Participant 2: Pronoun

Use NA if not applicable.

Participant 2: Date of Birth (YYYY/MM/DD). Enter 0000/00/00 if not registering second participant.

Pre-Primary. Please confirm that all participants have completed pre-primary.

Please choose oneYesNo

Participant: Proof of Vaccination Required. If my child(ren) will be 12 years old at the time of this program, I confirm that they will provide proof of vaccination and government issued identification upon arrival.

Please choose oneYesN/A

Emergency Contact 1: Name (First & Last)

Emergency Contact 1: Phone (xxx.xxx.xxxx)

Emergency Contact 2: Name (First & Last):

Emergency Contact 2: Phone (xxx.xxx.xxxx):

Authorized Pick-Up. First & Last Name, Relation

I give the following person(s) permission to pick up my child(ren), if different from Emergency Contacts. Use 'NA' if not applicable.

Pre-camp Supervision. Require pre-camp supervision from 8:30-9:00am.

Please choose oneYesNo

Post-camp Supervision. Require pre-camp supervision from 4:00-5:00pm.

Please choose oneYesNo

Allergy/Medical Information. Please inform us of any conditions the instructor should know about (i.e. asthma, diabetes, peanut allergies) as well as instructions for procedure to follow in the event of an incident. Include child's name, followed by information. Use 'NA' if not applicable.

Excursions Consent. Occasionally, an instructor may schedule a short excursion for the class.

Please choose oneYes, I give my child(ren) permission to go on supervised excursions. No, I do not give my child(ren) permission to go on supervised excursions.

Audio/Visual Consent. Photos and videos, may be gathered during our studio and Gallery programs. Please indicate your consent or refusal to allow the Art Gallery of Nova Scotia to use this data for promotional materials (in print, on website or social media). Note children’s name and personal details will not be shared.

Please choose oneYes, I hereby give consent. No, I do not give consent.

Other Information. Use this space if you are registering more than than two participants to provide: Name, Age, and other required information. Use N/A if note applicable.

Other Information. Please tell us anything about your camper(s) that will us help get to know them before the first session.

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