Run with the P.A.C.K. Registration

Explore Mural Painting: Learn about the Public Art and paint a Collaborative Community Mural!

**Run with the P.A.C.K**

(Public Art Camp for Kids)
**June 20 - 22 & 26 - 29, 2023**

Students will learn about public art and community mural painting. During the camp, students will learn about Owenwood Farm & Neighborhood Space as well as the various non-profit and/or mutual aid organizations stationed there. Students will work together to create a design that communicates the mission and values of the many groups stationed at Owenwood, who provide resources to under-served and under-resourced communities. This mural will benefit the Far East Dallas community and will communicate the importance of topics such as community, equity, justice, access, inclusion, and diversity. Student will come away with a deep understanding of mural painting techniques, the design process, collaboration, and team-work.

LEAD ARTIST & EDUCATOR : MOM - Brooke Chaney

CAMP DETAILS

TUE-THU, June 20 - 22 & MON-THU, June 26 - 29 I 8:30 AM - 12:30 PM

Where: Owenwood Farm & Neighborhood Space, John West Rd. Dallas, TX 75228

2 spots remaining out of 10 for students ages 12 -16.

Camp is FREE to attend. Water, lunch, and snacks are provided.

(Students with food allergies or dietary restrictions should be prepared to bring their lunch.)

Campers should be picked-up promptly at 12:30 pm.

Application & Wavier deadline - June 15.

New students will be given enrollment priority.

Questions? Contact byturri@creativeartscenter.org.

Note: The Creative Arts Center reserves the right to refuse enrollment or

can dismiss students with a history of dangerous behavior.

!!! PLEASE COMPLETE BOTH THE PROGRAM APPLICATION FORM & WAIVER FORM !!!

Program Application

In the students words, why do you want to participate in this camp? What are you looking to learn, gain, or experience through participation in this program?

Student Information

Student Name

First Name

Last Name

Pronouns

Please include pronouns teachers and program administrators should use when addressing the student when not using their first name.

Student Birth Date

YYYY

Student T-Shirt Size

Please select the student's t-shirt size.

Other

School Attended in 2022-2023

Grade Level in 2022-2023

Please state the grade level that the student will have most recently completed in the 2022 - 2023 school year.

Primary Contact Information - Guardian Information

Caregiver/Guardian/Parent Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

EMERGENCY CONTACTS

Please provide a contact other than the information you have provided above so that we have two contacts on file in the case of an emergency.

Emergency Contact Name

First Name

Last Name

Emergency Contact Phone

(###)

###

####

Emergency Contact Email

MEDICAL INFORMATION

Special Allergies/Medical Conditions

Please let us know if your student has any allergies and/or medical conditions in the box below. Note: This information will only be provided to instructors and administrators on a 'need to know basis'.

Student Access Needs and/or Potential Accomodations

Please state any student access needs or accommodations that instructors may need to be aware of. Note: This information will only be provided to instructors and administrators on a 'need to know' basis.

!!! PLEASE CONTINUE BELOW TO FINALIZE THIS APPLICATION BY COMPLETING THE WAIVER & RELEASE OF LIABILITY !!!

Creative Arts Center of Dallas & Owenwood Farm & Neighborhood Space, Waiver & Release of Liability

I, voluntarily elect to participate in certain classes, activities and/or programs (the “Activities”) to be conducted by, sponsored by, or held on premises occupied by, THE CREATIVE ARTS CENTER OF DALLAS, INC AND OWENWOOD FARM & NEIGHBORHOOD SPACE (the “Center” and "OFNS"). I understand that certain aspects of the Activities may involve hazardous activities or expose me to hazardous substances or conditions. I voluntarily assume the risk of any injury or harm to my person or property arising from my participation in such Activities or from my presence on the premises of the Center and/or OFNS. My participation in the Activities is at my own risk, and I understand that the Center and/or OFNS may not maintain insurance coverage to cover my claims or damages. I have fully investigated the nature of the Activities in which I intend to participate. I understand and acknowledge that certain aspects of the Activities may be physically demanding or dangerous. I assume all risks associated with the Activities in which I engage, including but not limited to the risk of physical injury and the risk of property damage or loss. The risks which I assume specifically include, but are by no means limited to: (1) the risk of traffic accidents sustained while traveling to and from classes or field trips: If I choose to travel in a vehicle driven by another person, I do so voluntarily and at my own risk; (2) loss or damage to clothing, jewelry, and other items of personal property, including class projects and art works; (3) risk of physical injury and other risks associated with use or misuse of tools, instruments, equipment, materials or supplies used in the Activities; (4) risk of physical injury or other risks associated with exposure to heat, fumes and noxious odors from paints or glazes, glass, metals, wood, glue, tape, caustic materials, chemicals, plaster, cement, silicone, and other substances used in the Activities or existing on the premises of the Center and/or OFNS; (5) health risks associated with lack of immediate access to medical facilities, physicians or other health care professionals. I warrant and represent that I have no mental or physical health condition that would prevent me from participating in the Activities, or that would pose a danger to me or to others at the Center and/or OFNS. I will immediately inform my instructor, other Center, and/or OFNS personnel if I feel unwell for any reason or unable to participate in the Activities. I agree that the Creative Arts Center of Dallas and Owenwood Farm & Neighborhood Space may use such photographs of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content. IN CONSIDERATION FOR THE OPPORTUNITY TO PARTICIPATE IN THE ACTIVITIES, THE RECEIPT AND ADEQUACY OF WHICH CONSIDERATION IS HEREBY ACKNOWLEDGED, AND INTENDING TO BE LEGALLY BOUND, I HEREBY RELEASE, ACQUIT, FOREVER DISCHARGE, AND AGREE TO DEFEND, INDEMNIFY AND HOLD HARMLESS THE CREATIVE ARTS CENTER OF DALLAS, INC. AND OWENWOOD FARM & NEIGHBORHOOD SPACE, ITS DIRECTORS, OFFICERS, EMPLOYEES, AND AGENTS OF AND FROM ANY AND ALL CLAIMS, DEMANDS, CAUSES OF ACTION, DAMAGES OF ANY NATURE, COSTS, LOSSES AND EXPENSES, KNOWN OR UNKNOWN, WHETHER IN CONTRACT OR TORT, ARISING FROM, RESULTING FROM, OR IN ANY MANNER CONNECTED WITH THE ACTIVITIES, AND WITH MY PRESENCE ON THE PREMISES OF THE CREATIVE ARTS CENTER OF DALLAS, INC AND/OR OWENWOOD FARM & NEIGHBORHOOD SPACE. THIS RELEASE IS INTENDED TO INCLUDE, BUT IS NOT LIMITED TO, ALL CLAIMS THAT COULD BE BROUGHT BY ANY THIRD PARTY IN CONNECTION WITH MY INJURY OR DEATH. This Waiver and Release is governed by, and construed in accordance with, the laws of the State of Texas. Should any provision of the Waiver and Release be illegal, invalid or unenforceable, such provision may be severed, and the remaining terms of this Waiver and Release will remain in full force and effect. This document contains the entire agreement between me, the Center, and OFNS concerning the matters addressed herein. The terms of this document are contractual, and are not mere recitals. This Waiver and Release form is inclusive for all students, age 12 and above, of the Creative Arts Center of Dallas, Inc and/or Owenwood Farm and Neighborhood Space.

Student Name

First Name

Last Name

Guardian Name

First Name

Last Name

CONFIRM

I agree to & accept the above terms.

Run with the P.A.C.K. Application & Waiver

Run with the P.A.C.K. Registration

Explore Mural Painting: Learn about the Public Art and paint a Collaborative Community Mural!

CAMP DETAILS

!!! PLEASE COMPLETE BOTH THE PROGRAM APPLICATION FORM & WAIVER FORM !!!

Program Application

!!! PLEASE CONTINUE BELOW TO FINALIZE THIS APPLICATION BY COMPLETING THE WAIVER & RELEASE OF LIABILITY !!!

Creative Arts Center of Dallas & Owenwood Farm & Neighborhood Space, Waiver & Release of Liability