Newspring Art Studio

After School Program Registration Form for Fall 2018 to Spring 2019

List the child enrolling in the Newspring After School program.

Does your school participate in the Community Eligibility Program?

Please complete this section for the child listed above.

Please complete the information for the parent/guardian.

Please provide contact information for an emergency contact other than the parent/guardian listed above.

Children will only be released to a parent or a person designated by the parent/guardian after verification of ID. I hereby authorize the program to allow my child to leave ONLY with the following persons. Please list name and telephone number for each.

I hereby give consent for my child(ren) to be transported and supervised for emergency medical care. In the event I cannot be reached to make arrangements for emergency medical care, I authorize the program to transport my child to:

For each section below, check the box(es) indicating whether or not you give your consent.

Open Studio is a Friday class for students ages 8-18 to work on independent projects.

Graphic design is for students 6 - 12th grade.

If possible, could you be specific? For example- if it was word-of-mouth- who did you hear it from?...was the program recommended to you by a teacher? ...did you receive Newspring's Program Flyer through an email?...did you learn about Newspring through Social Media? Thanks!

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