Arivva Online Visual Arts ProgramEnrollment Application
We welcome your student to Arivva’s online visual arts program in photography. Arivva offers art classes to high school students who are attending grades 9-12.
Art today is not just a collection of objects to see in a museum or an event with performers on a stage. Art can also be a way of cultivating habits, seeing, imagining, solving problems and acting with others in the world. During out of school time, Arivva provides a safe, nurturing environment where students are free to make decisions about their learning with the supportive guidance of caring mentors while working with working artists and industry standard tools and resources.
By filling out this form you acknowledge that you have read and consent to the terms outlined in it. This includes consent for emergency medical treatment outlined on page 3. Please read ALL paragraphs carefully.
PARENTAL WAIVER AND CONSENT*
- I give my student permission to participate in Arivva’s Spring 2020 Online Visual Arts Program in Photography.
- I understand that my student may be working with clay, glaze, hand tools, mechanical and/or electronic equipment, and/or chemicals as part of their coursework.
- I understand that participation in Arivva’s classes are made available at no cost to me or my student. In return, Arivva expects students to attend, behave well, and participate.
- I understand that Arivva cannot be responsible for any personal possessions that my student chooses to bring to Arivva programs.
- Emergency medical treatment. I understand that Arivva does not have medical professionals on staff, and that Arivva’s teachers or other staff will not administer or provide any medication to my child. I accept that in the event of an incident with my child, Arivva will make every effort to get in touch with the emergency contact listed above. If this person cannot be reached and/or immediate emergency action must be taken, I hereby authorize Arivva to secure all proper and required treatment deemed necessary under the then-existing circumstances to stabilize my child until such time as I can be reached to personally grant consent. I accept responsibility for costs of all such medical treatment that may be incurred.
- I understand that the information provided on this form will be used as needed in the event of an emergency, that it is my responsibility to notify Arivva of any changes to the information provided, and that my failure to return a signed copy assumes consent.
- Photo/Videotaping: I understand that photographs and video tapes may be taken during Arivva programming, and that these media are important for educational, funding, and promotional materials that celebrate and share accomplishments at Arivva. Therefore, I give Arivva my permission to use, in part or whole, the name, picture, performance, photograph and/or taped voice of my student and I release the program from any monetary compensation or from any and all claims resulting from such use. I acknowledge that Arivva will make every effort, but does not guarantee, to send special notification when the images are intended for use by another organization or institution.
- Web-based Services: In order for Arivva to provide your student with the most effective tools to ensure we are meeting our mission to educate and inspire youth through the arts, administrators, and
teaching artists may use educational web-based services and applications such as Zoom, Instagram, Facebook Live, Netflix Party, and others. Many of the Terms of Service and Privacy Policies of these applications state that, due to Federal Law, children must obtain parental permission to use their sites and often require an email address or other personal identifier information. I understand that parent signature on this form constitutes consent for students to use these educational, web-based applications.
- I understand that work produced by my student will belong to my student and may be exhibited by Arivva, or as part of offsite exhibitions, with my student’s permission. My student is welcome to maintain ownership of their work or contribute it to Arivva.
- I understand that in order to learn how well this program is working and to make improvements, Arivva staff and/or professional evaluators may conduct interviews, lead focus groups and/or administer questionnaires in which your student’s demographic information and school attendance data and grades may be included. All information will be treated confidentially and students’ names will not be revealed when results are reported.
I understand I may revoke any or all of this authorization by notifying the Arivva Executive Director in writing at firstname.lastname@example.org.
Arivva is a place of hope and opportunity.
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Please contact Executive Director, Dr. Dan Bissonnette, at email@example.com.
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Arivva is a 501(c)(3) nonprofit which incorporated in 2016 and began serving students in the summer of 2018. We are actively seeking a combination of legislatively directed funding and donations from regional foundations, businesses, and individuals to secure ample funding and establish our long term endowment.
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