Sign Up for Remote Lessons

Sign up for:
Remote Lessons for Teens; Tuesdays, 2–4 p.m.
Remote lessons for Kids; K–8th grade students, Mondays, 2–4 p.m.
Remote Preschool Lessons; Mondays, 11 a.m.–12 p.m.

ArtSeed Remote Lessons Online Application Form

Name (First name and Last Name) *
Date of Birth (you can type mm/dd/yyyy) *
Which lessons are you interested in? *
Remote Art Lessons for TeensRemote Art Lessons for KidsRemote Preschool Art Lessons
How have you come to know ArtSeed? *
School *

Parent/Guardian Information

Parent/Guardian's name *
Relation to student *
Email *
Preferred Phone *
work/mobile phone *
Home Address *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Name of School

In case of emergency please list below the person to contact and phone number. (You may enter second parent/guardian)

Name *
Relation to student *
Email *
Phone *
Address *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Preferred Medical Emergency Center *
Allergies to food or materials

Full cost of the program per student/per week is $400.00 (includes snacks, art supplies, & field trips) If the full cost of the program would be a financial hardship to your family, you may be eligible to apply for a full/partial scholarship.

If interested in the scholarship, what amount, if any, would you be able to contribute to support your youngster’s participation in the program?
$350$200$100other. You may also call Josefa 415-656-9849 or Aber 415-680-0567 to chat or arrange a visit.
please put other amount

III. ArtSeed Policies

The ArtSeed Program requires that each student’s parents/guardians understand and accept its policies on the following issues. Please read the policies listed below & sign your name below to indicate your understanding & acceptance of these policies

Discipline Policy *
A student’s disregard of the ArtSeed program rules will result in a temporary or permanent suspension from its program. If the student’s behavior is consistently unacceptable, ArtSeed reserves the right to dismiss the student from the program permanently. A student’s repeated disregard of ArtSeed’s collaboratively made and posted agreements with students may result in suspension from the program.I have read and understood this policy
Special Needs *
Any special behavioral, physical, emotional, psychological or medical needs of the student should be clearly discussed with Josefa Vaughan and her associates by the parent/guardian. Please explain your special needs clearly in a telephone call, an email or write it down on an attached page or on the back of this application.I have read and understood this policy.
Permission for Medical Treatment *
In the event of an emergency in which the parent/guardian cannot be contacted, emergency medical staff and the ArtSeed staff/volunteers may take appropriate action as needed for the student.I have read and understood this policy
Exposure to Sensitive Art Materials or Subject Matter *
Students participating in the ArtSeed Program may be exposed to sensitive materials (art supplies) or subject matters. ArtSeed encourages students and parents/guardians to let its instructors know when an art material or subject matter is uncomfortable for them. It is the responsibility of the student, and parent/guardian to communicate this to the ArtSeed instructors.I have read and understood this policy.
Photographs/Media/Artwork Waiver *
I give permission to ArtSeed to make and use photographs, videotapes, film, and audiotapes in which my son or daughter appears or the artwork of my son or daughter appears. ArtSeed may use these photographs, videotapes, film, and audiotapes in published materials, in other works of art, and on the Internet (World Wide Web) for artistic, educational, and publicity/promotional purposes for or related to the ArtSeed Program. ArtSeed may retain 50% of any sale of my son or daughter’s artwork, and may reproduce, sell and retain 50% of any sale of a reproduction of the artwork and/or writings he/she produces as a participant in the ArtSeed Program.I have read and understood this policy
General Release of Liability *
The undersigned agrees to release, waive, discharge, and hold harmless ArtSeed, its directors, officers, employees, agents, and volunteers from any and all claims, suits, losses, or related causes of action for damages, including but not limited to such claims that may result from any injury or illness, accident or any loss or damage to personal property or otherwise, during or arising in any way from participation in the ArtSeed program.I have read and understood this policy

I ACKNOWLEDGE THAT THIS GENERAL RELEASE OF LIABILITY OF ARTSEED IS BINDING ON ME PERSONALLY AND ON MY HEIRS, PERSONAL REPRESENTATIVES, SUCCESSORS, AND ASSIGNS. THE UNDERSIGNED HAS READ AND VOLUNTARILY SIGNS THE ARTSEED PARENT/GUARDIAN PERMISSION FORM

Entering your name (parent/guardian) and date on the fields below means that you understand and agree to the policies as stated above. This will be considered as a digital signature. *
Date *

ArtSeed is a non-profit tax-exempt fine arts / youth leadership organization under Internal Revenue Code 501(c)(3) & Revenue and Tax Code 27301d. Any charitable contribution, made w/o expectation of material benefit, is tax deductible. EIN: 52-2368513.

Thank you for applying. You will receive an email shortly after submission. Contact: vanbueren.aber@gmail.com, 415-680-0567 or josefa@artseed.org, 415-656-9849, Fax: 415-751-4442, www.artseed.org

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ArtSeed

An arts education nonprofit in San Francisco

Sign Up for Remote Lessons

ArtSeed Remote Lessons Online Application Form

Parent/Guardian Information

In case of emergency please list below the person to contact and phone number. (You may enter second parent/guardian)

Full cost of the program per student/per week is $400.00 (includes snacks, art supplies, & field trips) If the full cost of the program would be a financial hardship to your family, you may be eligible to apply for a full/partial scholarship.

II. Parent/Guardian Permission Form

I give permission to participate in ArtSeed’s Summer Intensive. I understand that you may be going to urban areas in transition that have incidents of gang-related activities & properties that may have been identified as containing environmental hazards.

I also give permission for the above-named student to participate in the following activities offered by the ArtSeed Program, through Josefa Vaughan and her associates.

If this student does NOT have my permission to leave the ArtSeed Program alone, he/she will be picked up by one of the following designated individuals:

III. ArtSeed Policies

The ArtSeed Program requires that each student’s parents/guardians understand and accept its policies on the following issues. Please read the policies listed below & sign your name below to indicate your understanding & acceptance of these policies

I ACKNOWLEDGE THAT THIS GENERAL RELEASE OF LIABILITY OF ARTSEED IS BINDING ON ME PERSONALLY AND ON MY HEIRS, PERSONAL REPRESENTATIVES, SUCCESSORS, AND ASSIGNS. THE UNDERSIGNED HAS READ AND VOLUNTARILY SIGNS THE ARTSEED PARENT/GUARDIAN PERMISSION FORM

ArtSeed is a non-profit tax-exempt fine arts / youth leadership organization under Internal Revenue Code 501(c)(3) & Revenue and Tax Code 27301d. Any charitable contribution, made w/o expectation of material benefit, is tax deductible. EIN: 52-2368513.

Thank you for applying. You will receive an email shortly after submission. Contact: vanbueren.aber@gmail.com, 415-680-0567 or josefa@artseed.org, 415-656-9849, Fax: 415-751-4442, www.artseed.org

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