Colorful Creations Registration Form

Parent/Guardian Signature: Date:

Student Information

Last Name: First Name:

Birth Date: Age: Gender:


Parent/Guardian Information

Name: Phone Number:

Street Address: City:

State: Zip Code:


Emergency Contact

Emergency Contact 1:
Name: Relationship:

Phone number:

Emergency Contact 2:
Name: Relationship:

Phone number:

Additional Info:

Please use the space below to provide any information you feel we should be aware
of such as allergies, health concerns, etc







Participant Contract: Enrolling at Colorful Creations at Buds and Muds Ceramics
constitutes your agreement that Colorful Creations at Buds and Muds Ceramics
cannot be held liable for any act or injury, illness, death, damage, loss, accident,
delay or irregularity which may occur during the course of the class. I as a
Parent/Guardian on behalf of a minor, do hereby waive, release, and discharge any
and all rights, demands and claims for damages that I may have against Colorful
Creations at Buds and Muds Ceramics.