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ValleyFriendshipCircle.com » Programs » Teen Kosher Culinary Circle

Inclusive Teen Kosher Culinary Circle.jpg

Dear Parent or Legal Guardian,

Please fill the form below to consent that your child is eligible to participate in a cooking/baking

class. Initial each section and sign and date the form at the bottom.  This form will expire 1 year

after signature unless otherwise specified. 

Click here for Cooking Class Lesson Plans and Dates For 2019-2020 

Participant 1 Profile
First Name
Last Name
Parent/Guardian First Name
Parent/Guardian Last Name
DOB
Address
City, State, Zip
Email
Cell Phone
 
Participant 2 Profile
First Name
Last Name
Parent/Guardian First Name
Parent/Guardian Last Name
DOB
Address
City, State, Zip 
Email
Cell Phone
 
Student 3 Profile
First Name
Last Name
Parent/Guardian First Name
Parent/Guardian Last Name
DOB
Address
City, State, Zip
Email
Cell Phone
Emergency Information
Emergency Contact 1
Phone
Relationship
Emergency Contact 2
Phone
Relationship
Family Physician
Phone
 
Payment Agreement
$180 per child and 20% off for sibling
Payment Information
Total Registration Cost   Card Number
Expiration   CVV
Additional Comments (optional):
Terms of Agreement

I permit my child's photos to be used for publicity purposes to assist the Valley Friendship Circle.

SAFETY: Culinary classes at Valley Friendship Circle are hands on and students are required to use various kitchen utensils and cooking equipment.  We are committed to safety and health at all times in our kitchen.  Kids are supervised at all times.  However, Parents should be aware, that participation involves using knives and other sharp utensils, and that children will be working with and in close proximity to kitchen equipment and hot surfaces. Classes may also involve handling of raw food items, including meat. Safe sanitary practices will be reviewed with the students. By signing this form, the parent/guardian releases Valley Friendship Circle/Teen Kosher Culinary Circle, the director, employees, and volunteer staff from all liability for injuries and/or damages incurred in connection with attendance in the cooking class.
SANITATION: Proper hand washing with warm water and soap is required after using the bathroom, sneezing, coughing or handling raw food products. Hand washing is the single most important activity that can be done to prevent food- borne illnesses.  If your child has had vomiting, diarrhea, jaundice, or fever over 101 in the last 24 hours, please inform staff. 
ATTIRE: Class participants are required to wear closed toe shoes. It is recommended that shoes be rubber soled and/or nonslip. Long hair should be tied back.
SCHEDULING: Valley Friendship Circle reserves the right to cancel classes and provide a full refund when class minimum registration numbers are not met.
PRIVACY: I agree to respect the privacy of all participants of Valley Friendship Circle/Teen Kosher Culinary Circle and to keep personal information confidential. 
PAYMENT AND CANCELLATIONS: Payment is due in full before the class. Food costs, recipes and culinary instruction are included in tuition. Reservations are taken on a first come, first serve basis. No refunds will be given for missed classes.
LATE PICK-UP POLICY: Parents are expected to pick up their child at the time that class ends, 12 noon. There is a 15 minute grace period. After 15 minutes, parents are charged $5 for every 15 minutes they are late. 
PHOTO, VIDEO OR OTHER RECORDING CONSENT: By signing this form the parent/guardian gives consent to Valley Friendship Circle to use images or filmed footage of cooking classes in printed materials or on the web for the purposes of promoting Teen Kosher Culinary Circle classes and Valley Friendship Circle programs. Please note there is no compensation for the use of your child’s likeness in any of our materials. Please indicate if you do not wish to have your child photographed or filmed 
Type yes or no and initial here. Yes means you give photo consent, No means you do not want any photos shared.

STANDARDS OF CONDUCT: I understand that participation in the Teen Kosher Culinary Circle is entirely voluntary and requires participants to abide by applicable rules and standards of conduct, which may be modified from time to time.
MEDICAL CONSENT: By signing this form the parent/guardian gives permission for medical treatment to be administered to their child by a qualified medical professional in the event of an emergency. Every effort will be made to contact the parent or emergency contact, but in the event that no one can be reached the signer authorizes Valley Friendship Circle, Chanie Baitelman, and staff to act on behalf of and in the best interest of the child.

Please inform us of any dietary restrictions BEFORE the beginning of class.  List them in the box below.  
It is IMPERATIVE that we are aware of ANY AND ALL ALLERGIES that the student has, regardless of how minor they are. Students are always encouraged to taste all items. Sometimes there are "blind tastings" We at Valley Friendship Circle/Teen Kosher Culinary Circle, want to ensure that your child is not given food to which they are allergic. List all allergies, symptoms to watch for, and specific instructions in case of an allergic reaction. 
Please also list any medical conditions that we should be aware of to help your child in class.

 

Signature
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