Print off the form below and mail it plus fees (check or money order) to:
Crockett Tavern Living History
Summer Workshops
C/O Sally A Baker CTM Site Director
Crockett Tavern Museum
2002 Morningside Drive, Morristown, TN 37814
__ May 23, 2014 9-2:30 (Paper-Making, Candle-Making,
Fire-Pit Cooking, Pioneer Chores)
__ June 13, 2014 9-2:30 (Soap-Making, Quill Writing, 18th Century Medicine, Old
Wives Tales, Foodways)
__ Both Workshops
Information:
Parent
Name: ___________________
Contact
#: _________________
Address: _____________________________________________________________
_____________________________________________________________________
Child(ren)
[names, ages and grade level]:
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
Email:
____________________
Emergency
Contact (name and
number other than number given): _____________________________________________________________________
Fees:
Preregistered
by May 14: $10 per student;
Family Maximum $30
After May 14: $14 per student; No Family Max
Permissions and
Code:
By
signing this form, I give permission for my family to participate in the
Crockett Tavern Museum Living History Workshops and:
- My Family and I will
actively and fully participate together in the activities and class
(lecture, discussion, hands-on) giving respect to speakers, other
participants and the Museum and its collections.
- Parents are responsible
for monitoring, caring, and correcting their children during the
programs. This is an interactive
family experience -- not a drop-off
program. Crockett Tavern speakers
and other leaders are not responsible for child(ren) other than to
cooperate to teach and encourage.
- I grant Crockett Tavern
Museum Living History Workshops and Crockett Tavern Museum permission to
photograph, film, audio/video tape, record and/or televise my and the
above listed child(ren)'s image and voice and biographical material in
whole or in part in any medium known or developed in the future without
any restrictions.
- I will not hold Crockett Tavern Museum,
Crockett Tavern Museum Living History Workshops and any other leaders or
members of this cooperative liable for any accidents or injury to myself
or the above listed child(ren).
- I understand the
opportunities for participation, fees and expectations.
- I willingly cooperate and
participate in the Crockett Tavern Museum Living History Summer
Workshop(s). I will explain these
expectations to my child(ren) expecting them to be aware and comply.
Signature:
______________________________________
Date: ___________________________________________
Fees
paid: _____________ Payment Form:
___________
Please also send your name and the number, ages and grades of students you will have in attendance to luvbnma@hotmail.com Thanks!
