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Summer School Application form

The Arts Council of New Westminster carries public liability insurance. I give permission for my child to participate in the day programs and activities. I understand that by applying online, I hereby waive all claims in excess of the public liability insurance, against the Arts Council staff and The Arts Council of New Westminster.

Personal Information

First Name:
Last Name:
Select Course:
Allergies:	Please list any allergies and disabilities that we should be aware of
Date of Birth:
Address:
City:
Please provide a phone number where you can be reached in case of emergency:
	Work:
	Home:
If emergency medical care is deemed necessary and I cannot be contacted, I authorize the staff person in charge to act on my behalf in granting permission for my child to receive emergency treatment.
BC Medical Insurance Number:
Name of Parent/Guardian:

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