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2019 Camp SpARTan Registration

Camp SpARTan registration

Camp SpARTan is a partnership between the University of Tampa Art Therapy Program and Arts4All Florida.  Camp will be held July 29 through August 2, 2019 from 9AM to 2PM daily at the Scarfone/Hartley Gallery.
1. Please tell us about your student *This question is required.
Does your student use an ABA therapist at school?
2. If you have a second student attending, please tell us about them.
Does your student use an ABA therapist at school?
3. My signature gives my approval and the following medical release:

In the case of a physical or any injury to registrant associated with an activity involving Arts4All Florida and/or University of Tampa Department of Art and Design, the registrant and contractor shall indemnify and hold harmless, and hereby releases, discharges, and acquits Arts4All Florida and University of Tampa Department of Art and Design (and their respective directors, officers, members, employees, agents and independent contractors) from and against any and all claims, damages and liabilities resulting from or associated with said injury or the treatment of said injury.

I/(my son/daughter has permission) will/to participate in Camp SpARTan.  I hereby give my consent to have a doctor of medicine or dentistry provide me (my son/daughter) with medical assistance and/or treatment and agree to be responsible financially for the reasonable cost of each assistance and/or treatment. *This question is required.
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Signature of
4. My signature on this document gives my consent to Arts4All Florida and/or the UT Department of Art and Design to photograph or videotape me/my child and to use such photos, voice or other likeness for future public awareness including print media, online news distribution, Arts4All Florida website, television and radio opportunities, video, promotional materials and other educational or exhibition purposes.  I also acknowledge that my/my child's work that is created through Arts4All Florida programs may be selected, displayed, used, or reproduced to benefit the ongoing statewide art programming of Arts4All Florida.
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Signature of
5. How many children in your family with disabilities will be attending? *This question is required.
6. Will you have any support siblings attending?