Workshop Registration

Hands-on Family Workshop: Look Again! Art That Changes (October 19, 2024, 2:00 - 3:30 pm)

**Please wait until you receive confirmation about the status of your registration. Filling out this form does not guarantee a spot.**

Teen Workshop Registration

PARTICIPANT INFORMATION

Full Name(Required)

Nickname

Gender Pronouns

Grade(Required)

Email address(Required)

Cell Phone Number(Required)

Please list any food allergies/dietary restrictions

EMERGENCY CONTACT

Parent/Guardian Name (main point of contact)(Required)

Parent/Guardian Relation to Participant(Required)

Parent/Guardian Email

Cell phone # where Parent/Guardian can be reached during the program:(Required)

ADDITIONAL INFORMATION + CONSENT

Is there anything that might be helpful for us to know (medical, other needs, etc.)?

Media Release (to be filled out by parent/guardian if participant is under 18 years old)(Required)

Yes

I hereby give permission to the Addison Gallery of American Art to use my child's name and photographic likeness in editorial and/or promotional material produced and/or published by the Addison in any form of printed or digital media. I waive any right to inspect or approve the finished product in which my or my child appears, or any copy that may be used in connection with it, now or in the future. I waive any right to royalties or other compensation arising from, or related to, the use of any photographic likeness.

Hands-on Family Workshop: Look Again! Art That Changes (October 19, 2024, 2:00 - 3:30 pm)

Teen Workshop Registration

PARTICIPANT INFORMATION

EMERGENCY CONTACT

ADDITIONAL INFORMATION + CONSENT

Bartlett H. Hayes Prize Recipients

2023:

Reggie Burrows Hodges

2025:

Tommy Kha