Art Camp Policy – Jackson Art Studio & Gallery

*Please note all fields are required.
Type NONE if any of the questions or options are not applicable.
Complete the form in full

Age

Parents Names (or legal guardians)

Parent Email

Phone Numbers where you can be reached during camp hours:

Home Parent #1

Cell Parent #1

Work Parent #1

Home Parent #2

Cell Parent #2

Work Parent #2

Mailing Address

City

State

Zipcode

If parents are not dropping kids off at camp:

Legal Guardian(s) Names:

Phone Numbers where the guardian(s) can be reached during camp hours:

Home: Guardian #1

Cell: Guardian #1

Work: Guardian #1

Home: Guardian #2

Cell: Guardian #2

Work: Guardian #2

Guardian Address

City

State

Zipcode

Will anyone else be picking up or dropping off your child at art camp:

Name of that person(s):

Emergency Contact Information: (Other than a parent or guardian. Please choose two local people)

Emergency Contact Name #1

Emergency Contact Home Phone #1

Emergency Contact Cell Phone #1

Emergency Contact Work Phone #1

Emergency Contact Name #2

Emergency Contact Home Phone #2

Emergency Contact Cell Phone #2

Emergency Contact Work Phone #3

Please list any allergies or medical conditions:

0 /

Does your child have behavioral issues? (please explain)

0 /

What tools or strategies will help your child during art camp?

0 /

Does your child have an IEP at school?

Is your child on any medications?

Please tell us anything else we should know about your child:

0 /

Is this your child’s first time at Jackson Art Camp?

YesNo

Is your child a NH or ME resident?

NHMEOther

If no, where is their permanent residency?

How long will your child be in state of NH prior to attending camp?(If less than two weeks, they will need a covid-19 test within three days prior to attending camp)

Will your child travel out of the state within 14 days of camp start?

Has anyone in your family traveled Internationally (outside the U.S.) within 14 days of camp start?

Will you be traveling by cruise ship, or domestically (within the U.S.) outside of NH, or ME on public transporta-tion (e.g., bus, train, plane, etc.) within two weeks of camp start?

Campers will be required to wear a child size mask at drop off, pick up and during part of the day at art camp. Does your child know how to put on a mask properly covering their nose and mouth without having help?

Do you feel your child can follow directions regarding socially distancing during art camp?

Parents or guardians will remain in their car at drop off. If this is your child’s first time at camp, would you like to set up a time to stop by stop prior to camp start?

As parent and/or legal guardians of the above child who is enrolled in a program with Jackson Art for the duration of the camp authorize Jackson Art to carry out standard first aid and CPR, including treatment for severe allergic reaction to insect stings and to arrange for emergency care for my/our child at a local hospital as deems necessary. I authorize hospital personnel to provide emergency medical treatment for my/our child

Print Name To Sign

Date

I/we also understand our child may be photographed during participation in art camp. Any photographs of my child may be used in brochures, press releases or promotional materials without any form of acknowledgement

Child Name

Date

I confirm that the information given in this form is true, complete and accurate.

Print Name To Sign

Date

JACKSON ART POLICIES
Creating a safe environment is essential to our program. Disruptive behavior, physical aggression, violence, disrespectful behavior towards others or their property, theft or possession/use of dangerous items will not be tolerated and could result in immediate dismissal from the program. No refunds will be administered for early dismissal/suspension. Damage to equipment due to misbehavior will be the expense of the parent.

BULLYING
Bullying occurs when one or more children (the bully/ies) target a child (the victim), such that a reasonable person would recognize that the bully’s action will physically or emotionally harm the victim, insult/demean the victim, or damage their property. Camp Administration has a zero tolerance policy pertaining to physical actions against others, stealing, bullying, and disrespect for staff and property. These actions are disruptive and result in negative experiences for fellow campers. Jackson ART staff reserve the right to suspend or terminate a camper’s participation at any time for failure to adhere to the rules and values of camp. Please understand that there will be no refunds given to children who are suspended or terminated for behavior issues.

ART CAMP RULES
Children are expected to display appropriate behavior at all times. To assure the maximum enjoyment of the
program by all participants, your child is expected to:

1. Be polite, courteous, and respectful to all participants, staff, and nature at all times.
2. Refrain from causing harm to self, other participants, and staff.
3. Use equipment, supplies, and facilities properly.
4. Stay with the group.
5. Listen quietly while others are speaking and wait for permission to speak.
6. Follow directions when they are given.

By signing below, I am stating that I have read and agree to abide by all of our policies at art camp. Futhermore, I certify that I have discussed all the policies, and their meanings and consequences, with my child(ren)

Print Parent/Guardian Name To Sign

Date

Print Camper Name To Sign

Date

JACKSON ART STUDENT INFORMATION: PLEASE FILL OUT THIS FORM PRIOR TO CAMP START

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