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Event Registration Form
Thank you for your interest in attending this event.
Your registration information helps us tailor our content and delivery to your unique needs.
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* Indicates required question
What is your first name?
*
Your answer
What is your last name?
*
Your answer
What is your email address? (personal email addresses are preferred to bypass spam filters)
*
Your answer
What event are you registering for?
*
May 9, Kids in the Kitchen: Parent and Child Workshop
Other:
Which best describes your role in attending this event?
Choose
Parent
Professional
Community Member
Student
Other
How many children will be attending this event with you?
Your answer
Age of child(ren) in attendance?
Your answer
(For
Kids in the Kitchen
workshop) If anyone attending has a food allergy, please list below:
Your answer
What is the zip code of your current home or residence?
Your answer
Are you Hispanic, Latino, or of Spanish origin?
*
Yes
No
Prefer not to answer
How would you describe yourself (select all that apply)
*
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or other Pacific Islander
White
Other
Prefer not to answer
Required
Are you military-connected (i.e., have you or your spouse served or currently serve in the US Armed Forces)?
*
Yes
No
Prefer not to answer
Which best describes you or your service member’s current military status?
*
Active Duty
National Guard
Reserve
Retired
Veteran
Civilian DoD Employee
No military affiliation
Prefer not to answer
Which service branch best represents you or your service member’s current affiliation?
*
Army
Navy
Air Force
Marine Corps
Space Force
Coast Guard
Not applicable
Prefer not to answer
Which best represents you or your service member's military rank?
*
E1-E5
E6-E7
E8 & above
W1-W2
W3-W5
O1-O3
O4-O6
O7 & above
Not applicable
Prefer not to answer
Do you provide unpaid care to a wounded, injured, or ill service member or veteran?
*
Yes
No
I don't know
Prefer not to answer
There may be photographing or videos/video taping done during event. As a result of your participation, your name and likeness may be used or displayed in MCEC print or video publications, web pages, multimedia, or displayed advertisements
If you have an extenuating circumstance that prohibits you from agreeing to this photo release, please add as much detail as you're comfortable with in the "other" section below so we can plan accordingly.
*
I have read and agree to the above photo release statement.
Other:
Course materials are under copyright, trademark or other intellectual property protections. Materials, methods, knowledge and skills may be used provided MCEC or third party author is cited appropriately. Permission is required prior to copying materials
*
I have read and agree to the above intellectual property statement.
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