Children Art Class Form - Heart for Art

Thank you

Child’s Full Name*

Child's Date of Birth*

Child's Date of Birth

Child's Address*

Does the Child have any food or skin allergies?

Yes
No

If answered yes above please could you provide further detail

Does the child have any SEN needs or registered disabled?

Yes
No

If answered yes above please could you provide further detail

Parent/Guardian Full Name*

Parent/Guardian Contact Number*

Parent/Guardian Email*

Second contact's name and number (in case of an emergency)*

All art work produced is the property of each child, however we often take photographs of their artwork for marketing purposes such as our website, social media and leaflets. Please note that although we provide aprons we do not take liability for any clothing that is stained or damaged.

I give consent to photographs of my child for business or social media sites

Yes
No

Please use this section for any relevant information that you would like to share:

Signature or full name*

Date*

Date