Enrollment

Name of Class, Workshop, or Camp *

Parent or Guardian Name *

Child's Full Name *

Child's Birth Date *

Name of School or Home Schooled *

Home Address *

City *

State/Province *

ZIP / Postal Code *

Phone Number *

Parent's Email Address *

Names of all adults who have permission to pick up child *

Emergency Name *

Emergency Phone Number *

Does your child have any medical/behavioral issues of which we should be aware? Please specify.

Does Catamount Arts and its funders have permission to use photos/videos of your child in promotional materials, social media, etc? *YesNo

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