Artist Intake Form

Please fill out the following form so we can gain more information about your artist!

Artist name

First Name

Last Name

Additional Artist Names

If you have more than one child participating in an Arts VanGo workshop, you can list their names here.

Preferred Name/Pronouns

If your artist prefers to be called a different name or nickname, please list it here. Please also let us know if your artist has preferred pronouns.

Artist birthday

YYYY

Parent/Caregiver Name

First Name

Last Name

Phone

(###)

###

####

Education Information

Tell us where you artist is currently enrolled.

Pre-K

Elementary school (public or private)

Middle school

Home school

Other

Address

Please let us know where the workshop will take place. This can be a residence, community center, school, church, etc. You can leave this section blank if you are filling out the form for an artist, but not the hosting the workshop.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Tell us about your artist

If you are part of a group of artists participating in a workshop, please indicate that here by listing the group name. (This could be a scout group number, a homeschool co-op name, or the name of the original person who booked the workshop.) Please let us know anything you think we need to know in order to keep your artist safe during the workshop. (This can include allergies to environment or food, special requirements or potential triggers your artist may have, or anything you think it would be helpful for us to know in advance.)

Photo Release

Check the "give consent" box below if you agree and consent as follows. A. I consent and authorize Arts VanGo, located in Haymarket, VA 20169 to use my likeness and/or the likeness of my child/children in any photograph, video or other digital media (“Photos”) in any and all of its publications, including print or web-based publications. B. I irrevocably authorize Arts VanGo to copy, edit, enhance, crop, or otherwise alter any Photo for use in their publications. I also waive any rights for approval or inspection of any Photos. C. I understand and agree that all Photos are the property of Arts VanGo, and will not be returned to me. D. I acknowledge that I am not entitled to any compensation or royalties with respect to the use of the Photos. E. I agree to release and forever discharge Arts VanGo and its affiliates, successors and assigns, officers, employees, representatives, partners, agents and anyone claiming through them, in their individual and/or corporate capacities from any and all claims, liabilities, obligations, promises, agreements, disputes, demands, damages, causes of action of any nature or kind, known or unknown, which I, and anyone claiming on behalf of me, may have or claim to have against Releasee in connection with this Release. F. I have carefully read and fully understand all the provisions of this Photo Release Form and am freely, knowingly and voluntarily giving consent.

Give consent

Do not give consent