APPLICATION
WASHINGTON COUNTY MUSEUM OF FINE ARTS
SATURDAY MORNING YOUTH ART CLASSES
FALL 2014
Students must be in 1st – 4th grade
Please Print
Name of Student: __________________________________________________________________
Age/Grade: ________________________________________________________________________
Member: __________ YES__________NO
Name of Parent: ___________________________________________________________________
Home Phone: _________- __________-_________ Cell Phone: _________-________ -_________
Address: _________________________________________________________________________
__________________________________________________
State: ______
Zip Code: ___________
Email Address: ___________________________________________________________________
Signature of Parent: _________________________________________________Date: _____________
(Note. Signature of parent is required and denotes permission for students to participate in art activities in the
museum, gardens, and surrounding areas of City Park, it also denotes permission for photographs to be taken and
used in promotion of the museum and the program. Please see full waiver on reverse.)
The above student has applied to be a member of the Saturday Morning Youth Program [8
weeks] which occurs on Saturdays, October 4, 11, 18, 25, November 8, 15, 22, [no classes
Nov. 1 & 29] 2014, 10:00 am -12:00 pm and final class December 6, 9:30-10:30 immediately
before the Children’s Holiday Reception.
PARENTS AND STUDENTS MUST BE ABLE TO COMMIT TO THE FOLLOWING
 Attend all classes. We know students get sick, so please notify us before the class if an absence is necessary
at 301-739-5727 (Note: Classes canceled due to weather will not be made up)
 At the start of the session each student will please bring ONE OLD Compact Disc CASE (for use in an
art project)
 Arrive on time with art journal assignments completed
 Maintain excellent behavior including abiding by the safety and etiquette guidelines of the museum
 Parents please bring your student promptly at 9:55 a.m. and pick up your student promptly at 12:00 p.m.
 Each student that completes all assignments will have their artwork in a SMYP Exhibition
 All students with perfect attendance will receive FREE admittance to the Children’s Holiday Reception!
The museum will provide all other materials.
Please note that this is an Application Form and does NOT denote that the above
enrollee has registered. A notification will follow upon acceptance.
Washington County Museum of Fine Arts • P.O. Box 423 • Hagerstown, MD 21741 •
301-739-5727 • 301-745-3741
www.wcmfa.org • [email protected]
Waiver and Release
To the Washington County Museum of Fine Arts, A non-profit institute whose address is PO Box 423, Hagerstown, Maryland 217410423. Student acknowledges that (I) he/she has enrolled in classes, workshops, programs and/or events to be offered by and/or at the
Museum, (II) he/she is willing to waive and to release the Museum and its agents from all claims, demands, causes of action,
liabilities, losses, damages and costs that may arise from any and all injuries and damages sustained by him/her while attending the classes,
workshops, programs and/or events.
Therefore, in consideration of the instruction to be provided by the Museum to the Student and other good and valuable consideration, the
receipt and sufficiency of which are hereby acknowledged, Student, for him/herself, his/her spouse, and his/her heirs, executors,
administrators, personal representatives and assigns, hereby AGREES that the Museum and its agents and employees shall have no liability
whatsoever to the Student for any injury or damage to the Student or to any property of the Student sustained by the Student while
attending the classes, workshops, programs and/or events, and hereby RELEASES the Museum and its agents and employees from any
and all claims, demands, causes of action, liabilities, losses, damages and costs that may arise from any and all injuries and damages
sustained by him/her while attending the course whether at the Museum or an on-site location.
I, the undersigned, hereby AGREE to the RELEASE of any and all photographs taken during the classes, workshops, programs
and/or events, filming, and/or videotaping for Washington County Museum of Fine Arts publicity purposes, i.e., public service
announcements, advertising, printed materials and other uses, and understand that the Washington County Museum of Fine Arts, a nonprofit organization, will use these photographs, films, and/or videotape to promote the Museum, its exhibitions and programs.
Washington County Museum of Fine Arts • P.O. Box 423 • Hagerstown, MD 21741 •
301-739-5727 • 301-745-3741
www.wcmfa.org • [email protected]