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Art+ 2025/2026 School Year
Please complete the form to apply for a position in Art+
Child's First Name
Child's Last Name
Child's Date of Birth
Please provide any allergy or medical information we should be aware of, including any prescribed medications your child is taking.
Guardian #1 First Name
Guardian #1 Last Name
Guardian #1 Phone
Guardian #1 Email
Guardian #2 First Name
Guardian #2 Last Name
Guardian #2 Phone
Guardian #2 Email
Emergency Contact Name
Emergency Contact Telephone
What Days will your child attend. Mornings (minimum of three)
Monday
Tuesday
Wednesday
Thursday
Friday
What Days will your child attend. Afternoons (minimum of three)
Monday
Tuesday
Wednesday
Thursday
Friday
Will your child be potty trained by the date of their start?
Dietary restrictions (we have a policy of not sharing food in case of allergies but it is helpful to know in case of special occasions):
None
Vegetarian
Vegan
Kosher
Glutuen-free
Dairy-free
Other
If other please describe.
Postal Address (we will use email as our primary mode of communication)
I authorise my child to be picked up from Art+ by someone other than myself
Yes
No
If yes please provide names and telephone numbers of people who are allowed to pick up your child.
I desire for my child to attend the Art+ program. I understand and accept the risks associated with participation. My child has no known medical conditions that would prohibit participation in the program. I agree and release Kaleidoscope Arts Foundation from liability resulting from any injury or illness sustained during participation in the program. I have read and understand the policies and guidelines of the ART+ Program.
I agree
I disagree
If there is anything further we should know about your child's specific needs, please let us know so we can tailor the program accordingly. Our aim is to ensure each child has an optimal experience.
Emergency Medical Care Authorization Please initial below giving consent to administer emergency medical care:
Thank you for completing our Art+ registration form! * Please note that a $100 (non -refundable) deposit will confirm your child's placement into the Art+program.
Submit
Thanks for submitting!
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