YOUTH CONSENT FORM Welcome to the AGGV Studio. We look forward to creating with you! Question Title * 1. Class Name Question Title * 2. Student Name Question Title * 3. Parent/Caregiver Name Question Title * 4. Parent/Caregiver Phone Number Question Title * 5. Email Address Question Title * 6. Art Classes NewsletterSubscribe to receive updates about classes, workshops, and more: Yes, please! Question Title * 7. Emergency Contact Name Question Title * 8. Emergency Contact Phone Number Question Title * 9. Important InformationPlease note any allergies, medications, or needs regarding your child that could be helpful for our instructors to know Question Title * 10. Authorized Pick-up InformationName + Phone Number of person(s) authorized to pick up your child 1. 2. 3. Please Note We cannot release your child to anyone not listed above We kindly ask parents/caregivers to be on time for both drop-off and pick-up Your child should arrive no more than 5 minutes before the class start time and must be picked up within 15 minutes of the class end time Question Title * 11. Permission to walk home independently I give permission for my child to walk home independently. Question Title * 12. Photo ReleaseOccasionally, we ask AGGV Staff to photograph and/or video record participants exclusively for Gallery use to help promote our programsPlease indicate if you do not want your child to be photographed or video recorded in class I do not want my child to be photographed/video recorded. Question Title * 13. I HAVE READ AND AGREE TO THE CONDITIONS OF THIS CONSENT FORMName of Parent/Caregiver Question Title * 14. I acknowledge that by entering my name above I am providing a digital signature Agree Question Title * 15. Date Date Date Next