Adult Cooking Classes JASC

Adult Cooking Classes Registration Form

January - March 2025 Classes
Cooking classes will be held at:

JASC's new building at 5700 N Lincoln Ave, Chicago, IL 60659.

Registration will cover January 2025 - March 2025

For any questions, please contact: programs@jasc-chicago.org.
Student Information
Name of Student*

First NameLast Name
E-mail*
example@example.com
Phone Number*
This is phone my

HomeWorkCell/Mobile
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
List all food allergies Student has (type N/A if none):*
Are you a JASC member?*

Yes, I am a JASC memberNo, I am not a JASC Member

Emergency Contact and Pick Up Procedures
Name of Emergency Contact*

First NameLast Name
Relationship to Student*
Phone Number of Emergency Contact*
Please enter a valid phone number.
Additional Pick-up Person

First NameLast Name
Additional Pick-up Person Phone Number
Please enter a valid phone number.
Liability Release Waiver and Photo Release Form
Liability Waiver

This Personal Injury Waiver (the "Waiver") is made by the undersigned for the purpose of utilizing the facilities and premises managed by Japanese American Service Committee, (hereafter the "JASC"), at the location of JASC, 5700 N Lincoln Ave., Chicago, IL 60659, and in the acknowledgment that in the utilization of the premises and facilities of the JASC, occupies risk of personal injury that may arise or happen at any time. In consideration of the JASC allowing the undersigned to make use of the venue and its facilities and equipment for the relevant purpose by which the JASC allows, the undersigned agrees to assume the foreseeable and unforeseeable risk of personal injuries related to the activity, and agrees to release, discharge, and hold harmless the JASC, its Board of Directors, and employees free from any and all liabilities, claims, cause of action, damages, or losses, which may be incurred by the undersigned in using said premises and its equipment and/or facilities, and which may arise from any reason whatsoever, specifically including, but not limited to, any negligence on the part of the owners, its employees, or losses arising from theft or for any other reason whatsoever. This Waiver shall be binding upon the parties, their respective heirs, representatives, successors, and assigns. In case any part of this Waiver be construed as improper or invalid, such invalidity will affect only that part of this Waiver and the rest shall remain valid and enforceable. Any alteration, modification, or amendment to this Waiver shall not be considered as valid unless otherwise written and signed by the undersigned herein.
I have read and fully understand the above Waiver and Consent form and by typing my name below hereby give my permission and agreement to these documents.
Please type your name above to give your consent.
Photo Release Consent
I hereby authorize Japanese American Service Committee ("JASC") and its representatives to use, print, publish, or display a picture and/or use my name for public relations or other purposes to benefit the JASC and its program. I have read and understand this consent form.

I hereby grant and authorize JASC to make use of my photos. I understand that I can withdraw my consent at any time.I do not allow the use of my photos in this registration form.
Signature

First NameLast Name

Adult Cooking Classes Registration Form

Student Information

Emergency Contact and Pick Up Procedures

Liability Release Waiver and Photo Release Form

Class Selection and Payment