Teen Program Registration Form : Programs & Events : The Columbus Museum

Teen Workshop Registration Form

Teen Name

First Name *

Last Name *

Date of Birth (Required)

Emergency Contact Information

Parent/Guardian Name

First Name *

Last Name *

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Phone (Required)

Alternate Contact Information

Name

If a parent cannot be reached, who should we call? Please list two emergency contacts.

First Name *

Last Name *

Relationship (Required)

Phone (Required)

Name

First Name *

Last Name *

Relationship (Required)

Phone (Required)

My child has the following medical conditions, allergies or needs:

In case of an emergency, The Columbus Museum has my permission to administer first aid and/or seek medical help for my child.

Yes, you have my permission
No, you do not have my permission

Name

First Name *

Last Name *

Date (Required)

Electronic Signature (Required)

For participating teens under 18 years of age, please complete the following section.

I understand face coverings and social distancing are required for my teen to participate in this event.

My child is over the age of 14 and has my permission to sign his/her/themselves in and out of this program.

Yes, my child has permission
No, my child does not have permission

Name

First Name *

Last Name *

Date (Required)

Electronic Signature (Required)

If your child is under the age of 13 or you have not given permission, you or an authorized adult must sign your child in and out of this program. Please provide the names of authorized adults who have your permission to pick up your child.

Name

First Name

Last Name

Please provide a copy of guardian’s photo ID. All other adults picking up a child will be required to present a photo ID to verify their identity.

Please upload copy of parent/guardian photo ID (Required)

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