2026 Summer Camp Registration Form

Parent/Guardian Information:*

First NameLast Name
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email:*
example@example.com
Phone Number:*
Please enter a valid phone number.Format: (000) 000-0000.
Secondary Contact:*

First NameLast Name
Secondary Contact Phone Number:*
Please enter a valid phone number.Format: (000) 000-0000.

Acknowledgements
YesNo
YesNo
Photography, video, and audio recording may occur during summer camp activities at the Art Museum of Southeast Texas (AMSET), and participants may appear in these materials. By selecting "yes," you grant permission for AMSET to use your child’s image or likeness for promotional, educational, and archival purposes without compensation. You also release AMSET from any related liability. If you prefer that your child not be photographed, select "no" and AMSET will make accommodations.*

YesNo
Person other than yourself that YOU authorize to take your child(ren) from the Art Museum of Southeast Texas building & grounds (list name and relation) :*
Phone Number of Authorized Person: *
Please enter a valid phone number.Format: (000) 000-0000.
Additional authorizations (please list name, relation, and phone number):
You should be aware of our disciplinary policy. It is simple and firm:

Your child will not be allowed to disrupt the art experience of any other child. In the event that your child continuously causes a disruption, he/she will be dismissed from Summer ArtVentures. You will be contacted and expected to collect your child immediately.

Your money will not be refunded.
Parent's Signature Required: *

Health Information

All health information provided will remain private and confidential with designated AMSET staff.
In case of emergency, or if you cannot be reached, the child's or family's physician is: *
Hospital Preference: *
Do you have health insurance?*
- Health Insurance Company:
- Group Policy:
- Does your child(ren) have any allergies? *
- Please list ALL allergies and, if registering multiple children, include names next to each:
- Will your child(ren) be bringing an epi-pen to camp?
- Does your child(ren) take any medications? *
- Please list ALL medications and, if registering multiple children, include names next to each:
- Other physical, mental or emotional conditions: *
- Should be Empty:

Summer ArtVentures 2026

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