ENG Flavor & Savor After School

Welcome to Flavor & Savor After School Cooking Class

REGISTRATION FORM
Flavor & Savor After School

Location: 300 Main Street, Windermere (Family Church)

Age: 6–14

Time: Every Thursday, 4–6 PM

Start Date: October 2, 2025

Teacher: Carol Vieira

WhatsApp: (689) 297-5977

Email: nutricionistacarovieira@gmail.com
Child information:*

First NameLast Name
Date of birth:*

MonthDayYear
Date
Age*
example@example.com
Responsible person information:*

First NameLast Name
Phone #:*
Please enter a valid phone number.
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency contact
Name*

First NameLast Name
Phone #*
Please enter a valid phone number.
Health and Safety:
Does the child have any food allergies?*

NoYes
If the answer to the previous question was YES, please specify below:
Does the child have any significant medical conditions?*

NoYes
If the answer to the previous question was YES, please specify below:
Prices and payment methods:
Package of 4 classes per month: $150.00 (8 hours total, each class lasting 2 hours)

Family Plan: 50% discount for each additional family member.

Payment methods:

Zelle to: carolnisenbaum@gmail.com (Carolina Vieira Nisenbaum) or cash.
WAIVER:

1. Assumption of Risk: I understand that the cooking class involves the use of sharp utensils, hot objects, slippery surfaces, and contact with various foods. I acknowledge the potential risk of cuts, burns, falls, allergic reactions, and other activity-related accidents.

2. Allergies and Medical Conditions: I declare that I am responsible for informing the organizers in advance of any food allergies, intolerances, health conditions, or dietary restrictions of the participant. I acknowledge that failure to provide such information may create risks and, in this case, I release the organizers from any liability.

3. Release of Liability: I agree to release and hold harmless the cooking class organizers, their representatives, instructors, staff, volunteers, and partners from any civil or criminal liability for any physical, emotional, or material harm that may occur during or after participation in the activity.

4. Emergency Medical Care: In the event of an accident or the need for medical care during the activity, I authorize the organizers to take the necessary measures. I understand that any medical or hospital costs will be my sole responsibility.
Authorization term:*

I, the undersigned, the child's legal guardian, authorize their participation in the Flavor & Savor After School Cooking Class. I understand that, although all safety precautions are taken, teacher Carolina Vieira Nisenbaum is not responsible for any accidents, injuries, or allergic reactions that may occur.
Signature of the Responsible Person:

Powered by Jotform SignClear
Should be Empty:

Welcome to Flavor & Savor After School Cooking Class

Emergency contact

Health and Safety:

Prices and payment methods: