Refunds may not be given after May 1st, 2020. I do my best to work with everyone to come up with a solution so do contact me if something comes up.
Child’s Name: _____________________________________________________________________
Parent’s Name: _____________________________________________ Phone Number: _____________________
How you heard about the class:_______________________
Please list any foods allergies, intolerances, and dietary restrictions that your child has:
In the event of an emergency, please contact the following:
Contact’s Name: _____________________________________ Relationship: __________________
Phone: _____________________________ Authorized to Pick Up Your Child From Class: ___ Yes ___ No
I hereby grant Becky’s Mindful Kitchen all rights and consent to copyright, use, publish, exhibit, or distribute all photographs and/or video of myself and/or my family to be used for Becky’s Mindful Kitchen website and any educational, training, or promotional materials without restriction. ______Yes ______ No
I understand the following:
My child will be exposed to a variety of foods during class and tasting foods throughout the program in a home kitchen.
I understand and acknowledge that Becky’s Mindful Kitchen cooking classes and events have inherent risks, dangers, and hazards related to preparing food in a home kitchen and working with tools and appliances and that my child’s participation in such classes and events may result in injury. I will provide closed toe shoes for my child to wear while in the kitchen.I assume full responsibility for any injuries or damages resulting from my child’s participation in this program. As the legal guardian of the minor child, I accept the risks inherent in the preparation, cooking, and eating of food that has been prepared during cooking classes. I understand that these classes and camps are educational and not a substitute for a meal and will make sure to provide an adequate meal prior to class- there is no meal provided during the camp or class. I hereby release Becky’s Mindful Kitchen, all owners and employees from any and all liability for damage, losses, or personal injury resulting from my child’s participation in any Becky’s Mindful Kitchen cooking class or event.
If my child’s behavior is disruptive to others and does not resolve with verbal warnings, I will come pick up my child and he/she may not be able to return to camp.
I understand that my child will be outside in a garden setting and interacting with chickens and goats. I will dress my child appropriate for the weather and provide sun and bug protection. I accept the risks inherent to gardening and interaction with chickens, goats and playing in the woods and release Becky’s Mindful Kitchen, all owners and employees from any and all liability for damage, losses or personal injury resulting from my child’s participation in outdoor activities. I understand the importance of checking my child for ticks.
I agree to not send my child to class if he/she has had a fever or diarrhea in the past 24 hours, an active cough, or frequently needs to blow his/her nose.
By signing this waiver, I acknowledge that I have carefully read it and understand the contents. I am aware that this is a release of liability. If I am signing on behalf of a minor, I am giving the minor permission to participate in classes and events at Becky’s Mindful Kitchen.