ARTIST'S NAME PHONE NUMBER

TYPE OF ART

EMAIL CITY STATE ZIP

IF THIS IS FOR A JR. MEMBERSHIP PLEASE COMPLETE THE INFORMATION BELOW
PLEASE NOTE THAT ALL JR. MEMBERS MUST HAVE THEIR PARENTS REGISTER FOR THIS SITE.

ARTIST'S AGE

PARENT'S EMAIL

I UNDERSTAND THAT MY CHILD'S ARTWORK WILL BE POSTED ONLINE. THE ONLY CONTACT INFORMATION USED WILL BE MY EMAIL ADDRESS OR PHONE NUMBER AS PROVIDED BY ME. I ALSO UNDERSTAND THAT THE ARTIST COLONY WILL CONTACT ME VIA TELEPHONE TO CONFIRM THIS INFORMATION.

INITIALED BY:

IF THIS IS FOR A FAMILY MEMBERSHIP PLEASE EMAIL THE NAMES, AGES AND CONTACT INFORMATION FOR EACH MEMBER THAT WILL BE PARTICIPATING.
PLEASE NOTE THAT ALL JR. MEMBERSHIP RESTRICTIONS STILL APPLY..