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Saturday Morning Childrens Art

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Registration Information

Student First Namerequired
Student Last Namerequired
Student Addressrequired
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Zip Coderequired
Current School Attendingrequired
Current Grade Levelrequired
What grade will you be entering for the 2022-23 school year.
Other
Current school you are attending
Has your child attended before?Has you child attended SMCA or SMCA Art Camp in the past?
Has you child attended SMCA or SMCA Art Camp in the past?
Parent/Guardian First Namerequired
Parent/Guardian Last Namerequired
Relationship To Studentrequired
Parent/Guardian required
Email Addressrequired
Emergency Contact Name
Emergency Contact Phone Number
Who will be picking up your child?

Please provide the following medical information required of all non-Norwich Free Academy students who participate in summer programs.

Pertinent Medical History
Allergies
Please list any food or environmental allergies your child may have.
Allergy MedicationDoes your child require medication for this allergy?
Does your child require medication for this allergy?
Allergy Medication
Please list the allergy medication.
Medication
Please list any medication(s) your child is currently taking and the reason for the medication.
Current health problems/concerns:
Special precautions
Are there special precautions you wish NFA staff to know concerning your child's medical history?
Camp Fee(s)requiredFee(s) include the cost of supplies.
Fee(s) include the cost of supplies.
Session OneWhich time slot would you like for Session One?
Which time slot would you like for Session One?
Session TwoWhich time slot would you like for Session Two
Which time slot would you like for Session Two
Session ThreeWhich time slot would you like for Session Three?
Which time slot would you like for Session Three?

Parent/Guardian Acknowledgement: I certify that I am age 18 or older. I have carefully read and freely sign the Acknowledgment & Assumption of Risk, Release, and Waiver of Liability. I fully understand and agree that this Acknowledgment & Assumption of Risk, Release, and Waiver of Liability is a legally binding agreement, that I on behalf of myself and the Student have given up substantial rights by signing it, that no oral or written statements or representations can or will alter the contents of this document, and that I and Student sign it freely and voluntarily without any inducement or undue influence. I agree that this agreement shall be governed by the laws of the State of Connecticut (excluding its conflict of laws principles), which shall be the forum for any lawsuits filed under or incident to this agreement or the Sports Activities. I further agree that this agreement is intended to be as broad and inclusive as is permissible by the laws of the State of Connecticut and that if any portion of this agreement is held to be invalid, it is agreed that the balance shall, notwithstanding, continue in full force and effect.

Discipline Policy - I understand that this is a Saturday program at Norwich Free Academy and that regular school rules apply. Although we do not expect any disciplinary issues, please be advised that any student participating is expected to behave properly and follow all directions given by the faculty and administration. Failure to do so may result in the removal from the program.

SMCA Cellphone Policy - While cellphones are a part of everyday life, it is program policy that cellphones are not to be used in class and should remain in backpacks or jacket pockets during the duration of the class period. This policy ensures students will be focused and provide their full and undivided attention during class. At the sole discretion of the teacher, students may be allowed to take images of their work for sharing purposes at the end of class. If there are medical or other reasons why this policy cannot be followed by your child, please contact Alysha Carmody. Your cooperation is appreciated.

NFA Public Relations/Student Names and Photos - Norwich Free Academy often uses images/photos of students on our website, social media, promotional materials and advertisements. If you do not want your child’s name and/or picture to appear in any NFA promotional materials, in print or digital form, please email communications@nfaschool.org with your child's name and the program they are attending.

*Norwich Free Academy may call 911 for transport to the nearest hospital in the event of an emergency.

My signature indicates: That I have read and agree to NFA's terms and conditions regarding medical emergencies, discipline, SMCA cellphone policy, and public relations, and that the medical information which I have provided is accurate and complete.

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Please type your name to sign this document.

Payment Information

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<p>Please complete the registration form and remit payment. Please return by mail to:</p> <p>NFA Arts Office<br /> Attn: Alysha Carmody<br /> 305 Broadway Norwich, CT 06360</p>
<p>Please complete the registration form and remit payment (checks payable to NFA). Please return by mail to:</p> <p>NFA Arts Office<br /> Attn: Alysha Carmody<br /> 305 Broadway Norwich, CT 06360</p>
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