Culinary Arts Youth Course Registration Request Form

Culinary Arts Youth Course Registration Request Form
Thank you for your interest in our culinary arts courses for youth! Submitting this form authorizes our office to register and bill the student listed on this form for the specified noncredit course(s). If additional information is needed for us to register a student for a course, or if a class you selected is no longer accepting registrations, we will contact you as soon as possible.

Also, the final part of this form requires parents/guardians to acknowledge the noncredit course tuition and fee liability policy. After Continuing Education registers a student using the information provided in this form, you are responsible for the full cost of the course(s) even if the student chooses not to attend, and participants who withdraw less than two weeks before a course begins are still liable for any materials fees.

Media & Medical Release Form

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Student Name
MEDIA RELEASE: Student has permission for SUNY Adirondack to photograph or videotape student for publications, media use and instructional purposes during this class.*

YesNo

If parents are not available in an emergency, notify:*

Rows	Name	Relationship to Student	Home Phone	Other Phone
Emergency Contact 1
Emergency Contact 2

Please specify any and all of the following (if applicable):
Operations or serious injuries (include dates):
Medical condition(s):
Allergies (including food, medication, insect stings, etc.):
Special diet:
Activity restrictions:
Medication (name) and how it is given:
MEDICAL RELEASE AUTHORIZATION: The above-named child has permission to engage in all prescribed SUNY Adirondack Continuing Education activities, except those activity restrictions noted above. By typing my name below, I certify that I am the legal guardian and/or have the legal ability to sign this authorization form on behalf of the above-named child. In the event of illness or accident, I hereby authorize and consent to the administration of all medical and/or surgical treatment(s) to my child by a licensed physician or hospital in the event I am not able to consult with the attending physician(s), attempts to contact me have been unsuccessful, and the attending physician(s) deem(s) it advisable to proceed with such treatment(s).*

Youth Course Code of Conduct

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Parents/guardians: Please acknowledge that you have read the code of conduct below by typing your name at the bottom of this page.

SUNY Adirondack Continuing Education is committed to offering youth courses in a safe and fun environment. We ask that all students and parents/guardians read this code together before the first day of the program, as it is each student’s responsibility to follow the policies listed below. We thank you for your help in creating a positive environment for all students.
- Be respectful, cooperative and courteous with fellow students and college staff.
- Be respectful of nature and the property of others, including college facilities, equipment and supplies.
- Do not eat or drink in the classrooms unless the teacher gives permission to do so.
- Do not make loud noises or run in the halls.
- Keep your hands and body to yourself. Unwelcome teasing, touching, horseplay, pushing, kicking, hitting, fighting or bullying will not be tolerated.
- Communicate politely and be a good listener. Don’t use foul language, gestures or harsh words. Follow directions.
- Wear appropriate clothing each day.
- Participate in all activities to the best of your ability. Be encouraging to other students to do the same.
- Weapons, look-alike weapons, or objects that may be used to threaten, intimidate or harm others or to damage property may not be brought to any SUNY Adirondack sites, including the Culinary Arts Center.
- Cellphones and electronic devices will only be used during appropriate times.
Students must inform college staff if they are experiencing a problem with another student or have other issues. If the staff are not informed about a problem, they cannot investigate, stop the problem or assist the student. It is not possible to anticipate every situation that may arise and in cases outside of those listed above, common sense and courtesy should prevail.

Consequences: Minor incidents will be brought to the student’s attention and suggestions will be made to correct the situation. Parents/guardians will be notified if there is repetition of a minor incident or if a student cannot follow the rules outlined in the Code of Conduct. Violation of the Code of Conduct is grounds for dismissal from Continuing Education youth courses. Refunds are not given when a student is dismissed from the program.
Parent/guardian name:*

Tuition & Fee Liability

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Important note about noncredit course tuition and fee liability:

Please note that after the Continuing Education office processes this registration using the information you provided on this form, a bill will be mailed to the student. After this happens, the student will be considered registered for the course(s) listed on the bill and is responsible for paying the full cost even if they choose not to attend. Unless otherwise indicated, participants who withdraw less than two weeks before a course begins are still liable for any materials fees. Some courses publish different refund cutoff dates to ensure timely purchase of course materials. Nonpayment may result in the balance being turned over to a collection agency.

If you wish to withdraw from a Continuing Education course and request a refund or bill adjustment, you must contact SUNY Adirondack Continuing Education at conted@sunyacc.edu and complete a Noncredit Course Withdrawal Form by 4 p.m. on the business day before the course begins. See our course drop, refund and tuition liability policy for additional important details.
By typing my name below, I confirm that I understand the information above and will pay the full cost of any youth culinary arts course(s) for which the Continuing Education office registers my child, even if they choose not to attend. I acknowledge that if I don’t contact Continuing Education to withdraw my child from a class at least two weeks before it begins, I may still be responsible for some or all of the course costs.*
Please click the "Submit" button below to submit your registration request. If a course is full and unable to take additional registrations, or if we need to clarify additional details to finalize your registration, we will contact you by phone and/or email as soon as possible.

You are welcome to contact SUNY Adirondack Continuing Education at 518-743-2238 or conted@sunyacc.edu with any questions.
Should be Empty:

Rows	Name	Home phone	Work phone	Cell phone	Email
Parent or guardian 1
Parent or guardian 2

Culinary Arts Youth Course Registration Request Form

Student & Course Information

Media & Medical Release Form

Youth Course Code of Conduct

Tuition & Fee Liability