Additional information
Parent/Guardian First and Last NameRequired
Parent/Guardian Email AddressRequired
Parent/Guardian Emergency Phone NumberRequired
Child's NameRequired
Please list any attendees your child will be carpooling with:Required
Please list any allerigies:Required
Will you be sending your child with an inhaler or Epipen?Required Please Select Yes No
Does your child have an IEP or 504 plan for disability-related accomodation?Required Please Select Yes No
If you answered yes to the question above, under which eligibility category does your child receive services? A Crystal Bridges staff member will contact you to discuss how we can best welcome your camper.Required Please Select Behavioral Disorder Learning Disability Autism Intellectual Disability Sensory Impairment Other Health Impairment Other None applicable
If you are registering for a digital art class, will you bring your own iPad or would you like one to be provided?Required Please Select Yes I will bring my own iPad No I will need an iPad provided Not Applicable
If you are registering for a photography class, will you bring your own camera or would you like one to be provided?Required Please Select Yes I will bring my own camera No I will need a camera provided Not Applicable
Only authorized persons will be allowed to pick up and proof of identification must be provided each day. Please list who is authorized to pick up your child with a phone number for each person.Required
I understand and appreciate that participation in the Crystal Bridges Museum of American Art (“the Museum”) children’s program involves potential, although highly unlikely, loss or damage to personal property and bodily injury, and I hereby assume all of said risks for myself and my child. In consideration of the use and availability of the services and facilities involved in the program by me and my child, I hereby agree to the extent allowed by law to release, relieve, hold harmless and indemnify the Museum and their respective officers, agents, instructors and employees from all liability claims arising out of any accident or injury suffered or incurred by me or my child while participating in the Museum program.
Required
In case of accident, injury or sudden illness, I hereby grant permission for my child to receive all appropriate first aid or emergency medical care necessary, and authorize that my child may be transported to a local medical facility.
Required
I give permission for the Museum to use, without limitation or obligations, photographs, video and/or audio recordings which may include my child’s image, voice or artwork for purposes of promotional or educational purposes.
Required
