Jackson Art Student Information: Please fill out this form prior to class start

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Type NONE if any of the questions or options are not applicable.

Complete the form in full

Phone Numbers where you can be reached during class hours:
If parents are not dropping kids off at class:
Phone Numbers where the guardian(s) can be reached during class hours:
Emergency Contact Information: (Other than a parent or guardian. Please choose two local people)
Other Student Information
Do you give permission for your child to be given a bag of popcorn, a popsicle and a bottle of water during the art class?
Is this your child’s first time at Jackson Art Class?
Will you be carpooling
As parent and/or legal guardians of the above child who is enrolled in a program with Jackson Art for the duration of the class 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
I/we also understand our child may be photographed during participation in art class. Any photographs of my child may be used in brochures, press releases or promotional materials without any form of acknowledgement
I confirm that the information given in this form is true, complete and accurate.

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 occurs when one or more children (the bully) 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. Class 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 classmates. Jackson ART staff reserve the right to suspend or terminate a student’s participation at any time for failure to adhere to the rules and values of class. Please understand that there will be no refunds given to children who are suspended or terminated for behavior issues

Children are expected to display appropriate behavior to assure the maximum enjoyment of the program by all participants.

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 at all times and respect outdoor boundaries.
5. Listen quietly while others are speaking.
6. Follow directions when they are given.
7. Do not share food/drink.

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

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