PD Day Information Form

STEP 1: Please complete the following form. When you submit this form, you will be taken to the class selection and payment portion of your registration (step 2).

If you have more than one children attending, do you want them to be together in the same group?

While we are pleased to offer french programming this year, limited spots are available with our french speaking instructors. Please indicate if you are interested. *** Please note our french language option is only available on PD-Days that are part of the CSAP school calendar. Spots will be filled on a first come, first served basis. ***

Emergency Contact

First

Second

Allergies and Medical Issues

Please inform us of any conditions the instructor should know about (i.e. asthma, diabetes, peanut allergies) as well as instructions for procedure to follow in the event of a problem.

Please indicate child's name first, followed by the issue or allergy. Please separate information for individual children with a semi-colon.

Permissions

Do you want to receive information about our education programs for children and families?

I give the following people permission to pick up my child(ren):

Excursions

Occasionally, an instructor may schedule an excursion for the class in the neighborhood.

Visual and Audio Release Form

Visual and audio records will be gathered during our studio and gallery programs. Visual and audio records may be in the form of photographs, audio recordings, videos, digital images and will only be used for non-commercial purposes relating to the Art Gallery of Nova Scotia Education Program mandate (such as on Art Gallery of Nova Scotia website, Journal, or promotional material).

I hereby give consent to the Art Gallery of Nova Scotia to use the information as described above, which may contain reference to my child’s name, which is included on the top of this form.

Note: Children’s names are not included in promotional material or online.

Submitting this form will take you to Step 2: Class Selection and Payment.