REgistration

Please review carefully before submitting. Errors on this form will influence the scheduling and logistics of your attendance.

Name *
Name
Date of Birth *
Date of Birth
Phone *
Phone
Student cell phone number.
Address *
Address
Attendance *
What workshops are you attending?
Are you booking housing in Rockhurst University's dorms?
This is only used for dorm housing purposes.
How did you learn about The Illustration Academy
Are you currently attending an art & design school?
Do you have any important notes regarding your attendance?
What time on Sunday will you be arriving in Kansas City? This question is only required for students attending from out of state.
What time on Sunday will you be leaving Kansas City? This question is only required for students attending from out of state.
Section
EMERGENCY CONTACT INFORMATION
Primary Emergency Contact *
Primary Emergency Contact
Emergency Contact Home phone *
Emergency Contact Home phone
Emergency Contact Cell Phone *
Emergency Contact Cell Phone
Emergency Contact Work Phone *
Emergency Contact Work Phone
Secondary Emergency Contact *
Secondary Emergency Contact
Emergency Contact Home phone *
Emergency Contact Home phone
Emergency Contact Cell Phone *
Emergency Contact Cell Phone
Emergency Contact Work Phone *
Emergency Contact Work Phone
18 or older? *
Please select "yes" below if you are 18 years of age or older. Students applying or attending the Illustration Academy must be 18+ or have written permission from a parent or legal guardian. If you are not 18+, this process must be completed by a parent or legal guardian. Please have the legal guardian contact us at hello@theillustrationacademy.com before taking further steps.
Confirmation *
I have read the entire Liability Release, The Illustration Academy’s Sexual Misconduct Policy and Rockhurst University’s Handbook. I fully understand each and I agree to be legally bound by all.