Student Information

First Name *

Last Name *

Age *

Birthday *

First Name

Last Name

Age

Birthday

First Name

Last Name

Age

Birthday

First Name

Last Name

Age

Birthday

Adult Contact Information

First Name *

Last Name *

Relationship *

Last Name

Street Address *

City *

State *

Zip Code *

Phone Number *

# Type *

Phone Number

# Type

Email Address *

First Name

Last Name

Relationship

Street Address

City

State

Zip Code

Phone Number

# Type

Phone Number

# Type

Email Address

Authorized Child Release

Name

Relationship

Phone Number

Name

Relationship

Phone Number

Name

Relationship

Phone Number

Allergies, Medications, Accomodations

Allergies *

Medications *

Accommodations *

Authorization

Authorization for Emergency Care:

In the event that I cannot be reached to make arrangements for emergency medical care at the time of illness or injury, I hereby authorize Tap Tap Art School to take my child to ________________________ (Name of Doctor or Hospital), and Tap Tap shall be permitted to seek medical services deemed necessary and appropriate through EMS/911. I understand that I am responsible for payment of medical services received.

Name of Hospital *

Authorization for Emergency Care *

I have read and agree to the Authorization for Emergency Care.

Release and Hold Harmless Agreement:

Whenever possible, classes, scheduling, and instructors will be as represented. However, any of these may be subject to change without notice. In consideration of Tap Tap Art School’s acceptance of my child enrollment, I hereby waive and release all rights and claims to damages against Tap Tap Art School. I accept all risk incidental to After-School, Care, Classes, Camps; and do hereby release Tap Tap Art School and its employees and representatives from all liability for injury during all program activities. It is further understood that Tap Tap Art School is not responsible for the loss of personal property.

Release and Hold Agreement *

I have read and agree to the Release and Hold Agreement.

Authorization for Transportation:

Tap Tap Art School has my permission to transport my child (ren) on Tap Tap field trips away from the site. I understand that all precautions will be taken to ensure the safety and health of my child.

Authorization for Transportation *

I have read and agree to the Authorization for Transportation.

Authorization of Video, Photographs, and Social Media: *

I grant full permission to Tap Tap Art School to use photographs, video tapes, and any other records of classes or programs involving my child for legitimate purposes, and can be posted to Social Media.

I DO NOT grant permission to Tap Tap Art School to use photographs, video tapes, and any other records of classes or the programs involving my child, and cannot be posted to Social Media.