Name of Parent or Guardian *

First Name

Last Name

Name of Student *

First Name

Last Name

Student's Date of Birth *

MM

DD

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Agreement of Terms of Online Class Environment *

I, the undersigned parent/guardian, give permission for my child to participate in the online class hosted by Michelle Baker (dba Rockin' Chalk)

I understand that the class will be conducted over [Zoom/Google Meet/etc.], and my child may be visible to the instructor and other participants.

I will ensure that my child is in a safe, appropriate environment during the session.

I may be required to assist my child with technical aspects if needed.

I can choose whether my child’s video/audio is on or off.

Permission to Record *

Classes are recorded for educational and safety purposes

I DO give permission for class sessions to be recorded for educational and safety purposes

Consent for Use of Work

Artwork created by your child could potentially be shared on Rockin' Chalk's social media or website as a positive form of promotion. We'd love your consent but it is NOT required.

I DO give consent to Rockin Chalk to post images of my child's art and credit them (first name only)

I DO NOT give consent to Rockin Chalk to publicly post art created by my child

Privacy *

I understand that [Michelle Baker (dba Rockin Chalk) will not collect or share my child’s personal information beyond what is necessary for class participation.

I acknowledge that I am responsible for supervising my child’s participation and that Michelle Baker (dba Rockin' Chalk) is not responsible for any technical difficulties or unintended interactions during the online session.

Today's Date *

MM

DD

YYYY