Summer Camp Registration for Not-Yet-Members Before beginning the registration process, please review the Liability and Procedural Agreement by clicking here.Parent/Guardian Name(s)Email AddressStreet AddressApartment, suite, etcCityState/ProvinceZIP / Postal CodeCountry AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaAustraliaArubaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCabo VerdeCayman IslandsCentral African RepublicChadChileChina, People’s Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d’IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGuernseyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People’s Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People’s Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauNorth MacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSaint HelenaSaint Pierre & MiquelonSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUS Minor Outlying IslandsUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemen Arab Rep.Yemen DemocraticZambiaZimbabwePhoneEmergency PhoneOther than parentStudent NameAgeSummer Camp ChoicesMagical, Mythical ArtDelicious ArtStreet Art Camp, VOL. 5Art of Horror, VOL. 2 Color Me CrazyStudent NameAgeSummer Camp ChoicesMagical, Mythical ArtDelicious ArtStreet Art Camp, VOL. 5Art of Horror, VOL. 2 Color Me CrazyStudent NameAgeSummer Camp ChoicesMagical, Mythical ArtDelicious ArtStreet Art Camp, VOL. 5Art of Horror, VOL. 2 Color Me CrazyStudent NameAgeSummer Camp ChoicesMagical, Mythical ArtDelicious ArtStreet Art Camp, VOL. 5Art of Horror, VOL. 2 Color Me CrazyIf any of the students have medical needs, allergies, or other special needs, please list details below:SignatureStart signing your signature hereYour browser does not support e-Signature field.I understand that my child is required to follow the CDC recommendations such as hand washing, social distancing, and wearing face masks when social distancing is not feasible. I will comply with the NIC’s staff decision to send my child home if s/he is not following the above-named guidelines or exhibits COVID19 symptoms such as coughing, sneezing and/or high temperature. I understand I will not be reimbursed the camps fees in case of my child’s failure to follow the guidelines or exhibiting COVID19 symptoms.Total Camp FeeSignatureStart signing your signature hereYour browser does not support e-Signature field.I have read and agree to the Liability and Procedural Agreements (PDF Linked above this form). I hereby release, hold harmless, defend and indemnify The Nicolaysen Art Museum, from any and all damages, injuries and causes of action which may accrue to or be asserted by me or any minor child of mine arising directly or indirectly from my minor child’s participation in Summer Art Camp at The Nicolaysen Art Museum.I give the Nic permission to release my child to the following people:Please list this person(s) Full Name, Phone Number, and Relationship to the student.I give the Nic permission to release my child (11+ only) to leave camp on his/her own.YesNoPermission for Student (11+) to leave camp on his/her own.Start signing your signature hereYour browser does not support e-Signature field. Send Message