Please complete this form for your child(ren) enrolled in a Museum of Art Fort Collins youth program or summer camp. Read the following before filling out the form:

  • This form is for up to three children. If you are enrolling more than three children, please submit a second form.
  • If two children have different primary parents or guardians, please submit a separate form for each child.
  • For the Medical section, please enter n/a in any field that does not apply to your child. If you have more than one child, please indicate which child you are providing medical information for (e.g., “Emma – peanut allergy”).
  • The Secondary Parent/Guardian and Emergency Contact sections are for the person we should reach if we cannot contact the primary guardian. If they are the same person, you may enter the same information in both sections.
  • Use the Notes for Staff field for anything else you’d like our team to know — behavioral needs, pickup arrangements, or anything that will help us support your child.
  • Once submitted, you will receive a confirmation. If you need to update any information before camp begins, please contact us at [email protected] or (970) 482-2787.

Youth Program Information Form

First Child

Child's Name(Required)
MM slash DD slash YYYY

Second

Child's Name
MM slash DD slash YYYY

Third

Child's Name
MM slash DD slash YYYY

Primary Parent/Guardian

Who we contact first
Name(Required)

Secondary Parent/Guardian

Who we contact if we cannot get a hold of the primary guardian
Name(Required)

Emergency Contact (if different from above)

Name

Medical

n/a if it does not apply – if you have more than one child, please indicate which one you are listing the information for

Additional Information

By typing your name above, you confirm that the information provided is accurate and complete.
MM slash DD slash YYYY