Art Programs at the Creative Art Factory

Child’s Information
Child’s Name:
Date of Birth:
Health Card #:
Expiry Date:
Medical Concerns:
Are there any allergies/medical regarding you or your child that we should be aware of?
If yes please explain:

Parent’s Contact Information
Parent/Guardian:
E-mail:
Address Line 1:
Address Line 2:
City:
Postal Code:
Phone Number:
Cell Phone:
2nd Parent/Guardian:
Phone Number:
Cell Phone:

Emergency Contact:
Name:
Phone:
Name:
Phone:

Program Enrollment:
Which program?:
Start Date/Time:
I/we, give permission for our/my child to participate in all of the arts program and related activities of Creative Art Factory located at 61 Ringwood Drive, Unit 7, Stouffville, Ontario.I/we grant permission for Creative Art Factory Staff/Directors to take whatever steps are necessary to obtain emergency medical care, if required. Any expenses incurred in carrying out these steps will be the responsibility of the child’s family.I/we the undersigned do hereby indemnify and agree to release Creative Art Factory its heirs assigns and all associated persons from liability for any incident, accident or injury sustained during my child or children’s, or own participation in art related activities.

I grant permission for myself and/or for my child or children to voluntarily participate in these arts related activities and will not make claim against, sue or attach the property of Creative Art Factory.

Creative Art Factory is not responsible for anything that may happen as a result of false information given on this form.

All fees include GST and are due fully on day of registration. Visa, MasterCard and Interac is accepted.

Cancellation policy:
No refunds will be given once workshops begin. A $75.00 cancellation fee will be charged to any cancellations up to one week prior to workshop commencement. In the event of limited or no enrollment in a workshop, Creative Art Factory reserves the right to cancel the class at any time prior to the first scheduled day and fees will be refunded. Prices are subject to change without notice.
Signature:
Date
(DD/Month/YYYY):