Music: Student Application Fields marked with * are required Student's Full Name* Date of Birth* 01/01/2017 Gender* Male Female Preferred Day* Tuesday Our classes are offered on Tuesdays and Saturdays. Please indicate which day of the week is preferable. Street Address* APT/UNIT City/Town* Zip Current Grade* K 1 2 3 4 5 6 Select a T-Shirt Size* Youth Small Youth Medium Youth Large Adult Small Adult Medium Adult Large Please list any medical information that needs to be on file, including allergies: Has your child studied art in school (as an elective or special course): Yes No Please select the number of years your child has participated in any art program outside of their traditional schooling: 0 1 2 3 4 If your child has formally studied art in the past, please indicate where: Parent/Guardian Full Name Primary Phone Number Secondary Phone Number Parent/Guardian Email Address* Method of Contact Phone Email Emergency Contact Name #1 Phone Number Relationship Emergency Contact Name #2 Phone Number Relationship Acknowledgement* I, the undersigned parent/guardian of (said minor), acknowledge that I have received, read, understand, and agree to abide by all AUAF student registration and attendance policies and procedures. I give permission for said minor to participate in the AUAF art program. I understand that by signing this authorization, I will not hold AUAF liable for any injuries incurred while participating in program activities in which I have enrolled said minor. I understand that AUAF is not responsible for any payments incurred due to medical care for said injuries.