RYW Winter 2020

Shifting Stories [ages 12-17], Mondays, Feb. 3- Mar. 9 $ 125.00

Box Full of Darkness [ages 14-17], Tuesdays, Feb. 4-Mar. 10 $ 125.00

Character Counts [ages 9-11], Wednesdays, Feb. 5-Mar. 11 $ 125.00

Metaphors Be Like [ages 12-15], Thursdays, Feb. 6-Mar.12 $ 125.00

Zines as a Means / Feb. 15 / Collage Zines $ 30.00

Zines as a Means / Feb. 22 / Food Writing & Recipe Sharing $ 30.00

Zines as a Means / Feb. 29 / Neurodiversity & Mental Health $ 30.00

Zines as a Means / Mar. 7 / Skillsharing & Instructional Writing $ 30.00

Scholarship Donation $ 10.00

Scholarship Donation $ 25.00

Scholarship Donation $ 50.00

GIFT CERTIFICATE: 6-week workshop $ 125.00

GIFT CERTIFICATE: Friday Night Writes Workshop $ 35.00

Enter coupon

Total $ 0.00

Young Writer Information

Young Writer's Name *

First Name Last Name

Age

School

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Parent/Guardian Information

Name

First Name Last Name

Home Number

Area Code Phone Number

Cell Number

Area Code Phone Number

E-mail *

Emergency Information

Emergency Contact's Name

First Name Last Name

Relationship

Phone Number

Area Code Phone Number

Alt. Phone Number

Area Code Phone Number

Please describe any medical conditions, allergies, special transportation arrangements or other pertinent information concerning your child. Thank you!

Informed Consent and Acknowledgement

I hereby give approval for my child’s participation in any and all activities prepared by Richmond Young Writers during the selected Richmond Young Writers workshop. I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Richmond Young Writers and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected workshops.

My child has permission to participate in short walks through Carytown including a visit to a coffee shop for a people watching expedition. I give permission for possible inclusion of a writing sample, group photo and/or video footage on the RYW website/blog.

Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

My E-Signature (please type)