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KID'S CAMP INFO

Please take a moment to tell us about your child. The more we know, the better everyone's experience.

Photo Release:

Please initial to give permission for photos to be taken and used in future marketing materials: letters, leaflets, social media or website publications.


Capital Cooks is not responsible for injury or allergic reaction during the time of the class and will not be responsible for any cost due to medical treatment.

Parents/emergency contacts will be notified immediately upon injury or allergic reaction.

Students will be using knives, heated elements, and other potentially dangerous kitchen tools and be exposed to various food ingredients to which they may be allergic.

Please initial to acknowledge consent.


First Participant's Name
First Name*
Last Name*
Phone*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
First Participant's Information
Please enter the four-digit order number from your receipt.

Any Allergies?

Any Special Needs? Let us know how we can accommodate your child.

Does your child carry medication? Please list.
First Participant's Signature*
Second Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Please enter the four-digit order number from your receipt.

Any Allergies?

Any Special Needs? Let us know how we can accommodate your child.

Does your child carry medication? Please list.
Third Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Please enter the four-digit order number from your receipt.

Any Allergies?

Any Special Needs? Let us know how we can accommodate your child.

Does your child carry medication? Please list.
Fourth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Please enter the four-digit order number from your receipt.

Any Allergies?

Any Special Needs? Let us know how we can accommodate your child.

Does your child carry medication? Please list.
Fifth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Please enter the four-digit order number from your receipt.

Any Allergies?

Any Special Needs? Let us know how we can accommodate your child.

Does your child carry medication? Please list.
Sixth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Please enter the four-digit order number from your receipt.

Any Allergies?

Any Special Needs? Let us know how we can accommodate your child.

Does your child carry medication? Please list.
Seventh Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Please enter the four-digit order number from your receipt.

Any Allergies?

Any Special Needs? Let us know how we can accommodate your child.

Does your child carry medication? Please list.
Eighth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Please enter the four-digit order number from your receipt.

Any Allergies?

Any Special Needs? Let us know how we can accommodate your child.

Does your child carry medication? Please list.
Ninth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Please enter the four-digit order number from your receipt.

Any Allergies?

Any Special Needs? Let us know how we can accommodate your child.

Does your child carry medication? Please list.
Tenth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Please enter the four-digit order number from your receipt.

Any Allergies?

Any Special Needs? Let us know how we can accommodate your child.

Does your child carry medication? Please list.
Parent or Guardian's Email Address
Email
Check to receive information, news, and discounts by e-mail.
Your signed waiver will be sent to the email address provided here and is available for download for three days via URL attachment.
Emergency Contact
First Name*
Last Name*
Emergency Contact's Phone Number*
Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name
First Name*
Last Name*
Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
Parent or Guardian's Information
Please enter the four-digit order number from your receipt.

Any Allergies?

Any Special Needs? Let us know how we can accommodate your child.

Does your child carry medication? Please list.
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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