{"id":9466,"date":"2025-10-22T12:13:36","date_gmt":"2025-10-22T16:13:36","guid":{"rendered":"https:\/\/yfc.ca\/highlands\/?post_type=program&#038;p=9466"},"modified":"2025-11-13T12:30:10","modified_gmt":"2025-11-13T17:30:10","slug":"artz-fusion","status":"publish","type":"program","link":"https:\/\/yfc.ca\/highlands\/program\/artz-fusion\/","title":{"rendered":"ARTz Fusion"},"content":{"rendered":"<section class=\"y-cig  guten-block\">\r\n\t<div class=\"grid-narrow\">\r\n\t\t<div class=\"y-cig--inner content-left vert-top\">\r\n\t\t\t<div class=\"y-cig--left\">\r\n\t\t\t\t\t\t\t\t\t<h2 class=\"y-cig--title\">ARTz Fusion<\/h2>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"y-cig--content\"><p>Curious about art or music?<\/p>\n<p>Come and check out ARTz Fusion. Youth ages 11+ can drop by every Wednesday after school to explore the arts in a safe and fun environment.<\/p>\n<p>3:30-4:00 Games &amp; (FREE) Snacks<br \/>\n4:00-5:00 Art &amp;\/or Music Challenges<\/p>\n<p>We\u2019ll start with small \u201csampler\u201d projects that can be completed in one afternoon. And as we stay curious and develop connections with each other, we\u2019ll soon move on to more ambitious collaborative projects. Who knows, maybe we\u2019ll start a jam band, publish a 16 page art journal, or produce a short film.<\/p>\n<\/div>\r\n\t\t\t\t\t\t\t<\/div>\r\n\t\t\t<div class=\"y-cig--right\">\r\n\t\t\t\t\t\t\t<div class=\"y-c-gallery extend\">\n\t\t\t<div class=\"y-c-gallery--sticky\">\n\t\t\t\t<div class=\"y-c-gallery--slick medium\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"y-c-gallery--slide\" style=\"background-image: url(https:\/\/yfc.ca\/highlands\/wp-content\/uploads\/sites\/28\/2025\/10\/Web-Content-more-detailed-updated.jpg);\" data-thumb=\"https:\/\/yfc.ca\/highlands\/wp-content\/uploads\/sites\/28\/2025\/10\/Web-Content-more-detailed-updated-300x225.jpg\"><\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\r\n\t\t<\/div>\r\n\t<\/div>\r\n<\/section>\r\n\n\n<section class=\"y-columned-content white two   guten-block\" >\r\n\t<div class=\"grid-narrow\">\r\n\t\t\t\t<div class=\"y-columned-content--inner\">\r\n\t\t\t\t\t\t\t<div class=\"y-columned-content--column y-color-responsive-text\"><h4><strong>Program Details<\/strong><\/h4>\n<p><strong>When:<\/strong>\u00a0<strong>Wednesdays, 3:30 &#8211; 5 PM<\/strong><br \/>\n<strong>Who:<\/strong> Youth Ages 11+<br \/>\n<strong>Bring your own instrument or use the ones here<\/strong><\/p>\n<p>Whether you&#8217;re new to art &amp; music or already love one or the other, this program is a great way to learn, grow, and connect!<\/p>\n<p>Contact: Seth at sveenstra@yfch.ca<\/p>\n<\/div>\r\n\t\t\t\t\t\t\t\t\t\t<div class=\"y-columned-content--column y-color-responsive-text\"><h4><strong>Program Needs<\/strong><\/h4>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">Art Supplies<\/span><\/li>\n<li aria-level=\"2\">Musical instruments<\/li>\n<li aria-level=\"2\">Music gear such as microphones, cables, portable speakers\/amplifiers<\/li>\n<li aria-level=\"2\"><a class=\"primary button\" href=\"https:\/\/yfc.ca\/highlands\/orangeville\/orangeville-donate\/\" target=\"_blank\" rel=\"noopener\">MONETARY DONATIONS<\/a> (click to donate online or learn of other ways to donate financially to help youth in this program).<\/li>\n<\/ul>\n<\/div>\r\n\t\t\t\t\t\t\t\t<\/div>\r\n\t<\/div>\r\n<\/section>\r\n\n\n\t<section class=\"y-gravity-form white  guten-block\" >\r\n\t\t<div class=\"grid-narrow\">\r\n\t\t\t\t\t\t<div class=\"y-gravity-form--inner\">\r\n\t\t\t\t<script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof 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gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n\/* ]]> *\/\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_68' ><div id='gf_68' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_68' id='gform_68'  action='\/highlands\/wp-json\/wp\/v2\/program\/9466#gf_68' data-formid='68' novalidate><div class='gf_invisible ginput_recaptchav3' data-sitekey='6Lfq1YsaAAAAAIlCN1-uzuUjef83MGbopf9xeWCd' data-tabindex='0'><input id=\"input_fc591bed6714b9b44c0ec9a984210e56\" class=\"gfield_recaptcha_response\" type=\"hidden\" name=\"input_fc591bed6714b9b44c0ec9a984210e56\" value=\"\"\/><\/div>\n        <div id='gf_progressbar_wrapper_68' class='gf_progressbar_wrapper' data-start-at-zero='1'>\n        \t<h3 class=\"gf_progressbar_title\">Step <span class='gf_step_current_page'>1<\/span> of <span class='gf_step_page_count'>3<\/span><span class='gf_step_page_name'><\/span>\n        \t<\/h3>\n            <div class='gf_progressbar gf_progressbar_blue' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_blue percentbar_0' style='width:0%;'><span>0%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_68_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><ul id='gform_fields_68' class='gform_fields top_label form_sublabel_above description_above validation_below'><li id=\"field_68_23\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">Youth Info<\/h2><div class='gsection_description' id='gfield_description_68_23'>ArtzFusion is designed for youth from the ages of 11-18 years.  This is a weekly program for youth that occurs on Thursdays from 3:30 &#8211; 5 PM.  Register online.<\/div><\/li><li id=\"field_68_3\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Youth&#039;s Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_68_3'>\n                            \n                            <span id='input_68_3_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_68_3_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                    <input type='text' name='input_3.3' id='input_68_3_3' value=''   aria-required='true'     \/>\n                                                <\/span>\n                            \n                            <span id='input_68_3_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_68_3_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                            <input type='text' name='input_3.6' id='input_68_3_6' value=''   aria-required='true'     \/>\n                                                        <\/span>\n                            \n                        <\/div><\/li><li id=\"field_68_4\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_68_4'>Birthdate (for youth ages 11-18 years)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_4' id='input_68_4' type='text' value='' class='datepicker gform-datepicker dmy datepicker_no_icon gdatepicker-no-icon'   placeholder='dd\/mm\/yyyy' aria-describedby=\"input_68_4_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_68_4_date_format' class='screen-reader-text'>DD slash MM slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_68_4' class='gform_hidden' value='https:\/\/yfc.ca\/highlands\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_68_25\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Youth Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_68_25' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_68_25_1_container' >\n                                        <label for='input_68_25_1' id='input_68_25_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                        <input type='text' name='input_25.1' id='input_68_25_1' value=''    aria-required='true'    \/>\n                                   <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_68_25_2_container' >\n                                        <label for='input_68_25_2' id='input_68_25_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                        <input type='text' name='input_25.2' id='input_68_25_2' value=''     aria-required='false'   \/>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_68_25_3_container' >\n                                    <label for='input_68_25_3' id='input_68_25_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                    <input type='text' name='input_25.3' id='input_68_25_3' value=''    aria-required='true'    \/>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_68_25_4_container' >\n                                        <label for='input_68_25_4' id='input_68_25_4_label' class='gform-field-label gform-field-label--type-sub '>Province<\/label>\n                                        <select name='input_25.4' id='input_68_25_4'     aria-required='true'    ><option value='' selected='selected'><\/option><option value='Alberta' >Alberta<\/option><option value='British Columbia' >British Columbia<\/option><option value='Manitoba' >Manitoba<\/option><option value='New Brunswick' >New Brunswick<\/option><option value='Newfoundland and Labrador' >Newfoundland and Labrador<\/option><option value='Northwest Territories' >Northwest Territories<\/option><option value='Nova Scotia' >Nova Scotia<\/option><option value='Nunavut' >Nunavut<\/option><option value='Ontario' >Ontario<\/option><option value='Prince Edward Island' >Prince Edward Island<\/option><option value='Quebec' >Quebec<\/option><option value='Saskatchewan' >Saskatchewan<\/option><option value='Yukon' >Yukon<\/option><\/select>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_68_25_5_container' >\n                                    <label for='input_68_25_5' id='input_68_25_5_label' class='gform-field-label gform-field-label--type-sub '>Postal Code<\/label>\n                                    <input type='text' name='input_25.5' id='input_68_25_5' value=''    aria-required='true'    \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_25.6' id='input_68_25_6' value='Canada' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_68_5\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_68_5'>Youth&#039;s Email<\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_5' id='input_68_5' type='email' value='' class='large'     aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_68_6\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_68_6'>Youth&#039;s Phone<\/label><div class='gfield_description' id='gfield_description_68_6'>Or adult&#8217;s phone if not applicable for a youth<\/div><div class='ginput_container ginput_container_phone'><input name='input_6' id='input_68_6' type='tel' value='' class='large'    aria-invalid=\"false\" aria-describedby=\"gfield_description_68_6\"  \/><\/div><\/li><li id=\"field_68_54\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_68_54'>Refreshments<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_68_54'>LIght refreshments will be provided weekly.  Please share any food allergies or dietary restrictions.  If none, please type N\/A.<\/div><div class='ginput_container ginput_container_text'><input name='input_54' id='input_68_54' type='text' value='' class='large'  aria-describedby=\"gfield_description_68_54\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_68_50' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> <a type='button' href=\"javascript:void(0);\" id='gform_save_68_2_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary'  > Save and Continue Later<\/a>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_68_2' class='gform_page' data-js='page-field-id-50' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_68_2' class='gform_fields top_label form_sublabel_above description_above validation_below'><li id=\"field_68_24\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">Parent &amp; Emergency Info<\/h2><\/li><li id=\"field_68_26\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Parent\/Guardian Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_68_26'>\n                            \n                            <span id='input_68_26_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_68_26_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                    <input type='text' name='input_26.3' id='input_68_26_3' value=''   aria-required='true'     \/>\n                                                <\/span>\n                            \n                            <span id='input_68_26_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_68_26_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                            <input type='text' name='input_26.6' id='input_68_26_6' value=''   aria-required='true'     \/>\n                                                        <\/span>\n                            \n                        <\/div><\/li><li id=\"field_68_27\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_68_27'>Parent\/Guardian Main Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_27' id='input_68_27' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_68_28\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-half field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_68_28'>Parent\/Guardian Alternate Phone<\/label><div class='ginput_container ginput_container_phone'><input name='input_28' id='input_68_28' type='tel' value='' class='large'    aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_68_29\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_68_29'>Parent\/Guardian Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_29' id='input_68_29' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_68_51' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_68_51' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> <a type='button' href=\"javascript:void(0);\" id='gform_save_68_3_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary'  > Save and Continue Later<\/a>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_68_3' class='gform_page' data-js='page-field-id-51' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_68_3' class='gform_fields top_label form_sublabel_above description_above validation_below'><li id=\"field_68_30\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">Waivers &amp; Consent<\/h2><\/li><li id=\"field_68_35\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Youth Consent<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description gfield_consent_description' id='gfield_consent_description_68_35' tabindex='0'>As a participant in this program, I (the youth listed above), agree to make this a safe space for myself and all participants, and will abide by the group rules established.  I understand that failure to do so could result in my being sent home.<\/div><div class='ginput_container ginput_container_consent'><input name='input_35.1' id='input_68_35_1' type='checkbox' value='1'  aria-describedby=\"gfield_consent_description_68_35\" aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_68_35_1' >I agree.<\/label><input type='hidden' name='input_35.2' value='I agree.' class='gform_hidden' \/><input type='hidden' name='input_35.3' value='65' class='gform_hidden' \/><\/div><\/li><li id=\"field_68_34\" class=\"gfield gfield--type-signature gfield--input-type-signature gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_68_34'>Youth Signature<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><input type='hidden' value='' name='input_34' id='input_68_34_signature_filename'\/><div class='gfield_signature_ui_container gform-theme__no-reset--children' ><div id='input_68_34_Container' class='gfield_signature_container ginput_container' style='height:180px; width:300px; ' ><canvas id='input_68_34' width='300' height='180' style='border-style: Dashed; border-width: 2px; border-color: #DDDDDD; background-color:#FFFFFF; cursor: url(https:\/\/yfc.ca\/highlands\/wp-content\/plugins\/gravityformssignature\/assets\/img\/pen.cur), pointer;'><\/canvas><\/div><div id='input_68_34_toolbar' style='margin:5px 0;position:relative;height:20px;width:300px;max-width:100%;'><img id = 'input_68_34_resetbutton' src='data:image\/png;base64,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' style='cursor:pointer;float:right;height:24px;width:24px;border:0px solid transparent' alt='Clear Signature' \/ ><\/div><input type='hidden' id='input_68_34_data' name='input_68_34_data' value=''><\/div><\/li><li id=\"field_68_22\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Media Waiver<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_68_22'>I permit photos\/videos of my teen (listed above) be taken on this trip for promotional purposes, including posting photos\/clips on Youth Unlimited | YFC Highlands&#8217; website and social media, and with our national and international offices.<\/div><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_68_22'>\n\t\t\t<li class='gchoice gchoice_68_22_0'>\n\t\t\t\t<input name='input_22' type='radio' value='Yes' checked='checked' id='choice_68_22_0'    \/>\n\t\t\t\t<label for='choice_68_22_0' id='label_68_22_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_68_22_1'>\n\t\t\t\t<input name='input_22' type='radio' value='No'  id='choice_68_22_1'    \/>\n\t\t\t\t<label for='choice_68_22_1' id='label_68_22_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_68_55\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Communication Consent<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description gfield_consent_description' id='gfield_consent_description_68_55' tabindex='0'>I\/We agree to permit Youth Unlimited YFC Highlands staff or volunteers to communicate with the participant via telephone, email, social media (Facebook, Instagram, Discord, etc.) or text for the purpose of dissemination of information. <\/div><div class='ginput_container ginput_container_consent'><input name='input_55.1' id='input_68_55_1' type='checkbox' value='1'  aria-describedby=\"gfield_consent_description_68_55\" aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_68_55_1' >I agree.<\/label><input type='hidden' name='input_55.2' value='I agree.' class='gform_hidden' \/><input type='hidden' name='input_55.3' value='65' class='gform_hidden' \/><\/div><\/li><li id=\"field_68_31\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Parent\/Guardian &#8211; Wellbeing Consent<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description gfield_consent_description' id='gfield_consent_description_68_31' tabindex='0'>I, the Parent\/Guardian listed above, understand that my son\/daughter will be attending the ArtzFusion Program offered by Youth Unlimited YFC Orangeville at 9 Centre St. Orangeville on the selected date(s) and will ensure that the participant has proper medical coverage. We authorize the administration of any first aid treatment necessary in this program, and in the case of medical emergency, give permission to the Physician selected by those responsible to hospitalize and secure proper treatment for the above named participant. We understand that every effort will be made to contact parents or guardians before such action. 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