Student Registration Form - The Culture Matters Children's Cooking Class

The Culture Matters

Children's Cooking Class
Parent/Guardian Info
Name*

First NameLast Name
e-mail*
Primary Phone*

Area CodePhone Number
Work Phone

Area CodePhone Number
Cell Phone

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Emergency Contact (If Parent/Guardian cannot be reached)*
Relationship to Student*
Emergency Phone*

Area CodePhone Number
Billing Infomation differs from Parent/Guardian Information
Please note: Parent/Guardian listed above assumes primary responsibility for account maintenance. Billing Info is for contact information only.
Billing Name*

First NameLast Name
e-mail*
Primary Phone Number*

Area CodePhone Number
Cell Phone Number

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student Info
Student Name*

First NameLast Name
Date of Birth*

MonthDayYear
Age
Grade in School 2025-2026
Student email
Flint ONLY: Which class session(s) are you interested in: (Select Not Applicable if not Flint)*

July Classes 12:00 pmAugust Classes 4:00 pmBothNot Applicable
Student Cell Phone

Area CodePhone Number
Has your child taken a The Culture Matters Cooking course before?*

YesNo
Has your child taken any cooking course(s) before?*

YesNo
Has your child been taught kitchen safety or etiquette?*

YesNo
Is there any area of the kitchen you are uncomfortable with your child participating in?*

YesNoOther
Does your child have any allergies?*

YesNo
If yes, what allergies?
Does your child have any accessibility needs?*

YesNoOther
Portions of this program will be photographed and/or videotaped; do we have your consent to include your child in photographs or videos?*

YesNo
Do you anticipate your child being absent for any of the session? (Please list dates)
Is there anything else you believe we should be aware of?
We will make any necessary corrections and bill your account. Payment and a current account is required to secure a place in each class. Class sizes limited.
Notes:
Terms and Conditions
Today's Date

MonthDayYear
Date
By checking 'I Agree' below and submitting this form, you, the Parent or Guardian of the above student(s), agree to release "Gottagetit and TC McClain Enterprises", including instructors and assistants from liability for any and all injuries which may occur while training, practicing, performing, or during any class or activity. You also agree that you are responsible for health and accident insurance and any medical costs incurred due to injury. You give permission for emergency medical transportation and treatment of your student(s) at your expense should the need arise. You also give your permission for the public display of any studio visual images that your child may appear in.
I Agree
Registration Fee
prevnext( X )
Student Registration$50.00
This is required to secure your child's spot in the class (EXCEPT KALAMAZOO), and will be due upon notification of selection. If you require a scholarship please contact Taylor (810)877-5078 or tcmcclain@gottagetit.org

Quantity

Total $0.00

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Should be Empty:

The Culture Matters

Parent/Guardian Info

Student Info

Terms and Conditions