Registration, Liability Waiver and Media Waiver

Slow Food in the Tetons After-School Farm-to-Table Cooking Class Registration, Liability Waiver and Media Waiver

Sign up for Mondays OR Wednesdays (just Wednesdays for the first session) to learn gardening and cooking skills with Slow Food farmer and chef Ian McGregor and Dayna Ferguson and Summit Innovations School instructor Brian Hager. Students will meet at Jackson Hole Middle School and walk to Summit Innovations School as a group. Parent pick up time at 6pm Summit Innovations School.

Open to 4th and 5th grade Elementary students, Middle School students and Summit Innovations School students

Classes held at the Summit Innovations School kitchen and greenhouse

MORE INFORMATION:
• Cost $175
• Parents are responsible for picking up at Summit Innovations School
• Students participate in greenhouse and cooking activities

You must fill out one form for each child attending the camp. Need based scholarships are available, please email ashley@tetonslowfood.org to learn how to apply.

Pay online with this form OR
Mail a check to:
Slow Food in the Tetons
PO BOX 7290
Jackson, WY 83002.

Basic Child Information
Test
Students Name *
Your answer
Select Session(s) and Day of the Week *
Curriculum will change per session, however it will stay the same on Monday and Wednesday of the same session. Therefore it is okay to sign up for multiple sessions, however please only select Monday OR Wednesday.
Required
Grade *
Parent/Guardian Name *
Your answer
Home Address *
Your answer
Mailing Address *
Your answer
Phone Number *
Your answer
Email *
Your answer
Emergency Contacts
Please list at least two contacts. Include names phone numbers *
Your answer
Important and Relevant Medical Information
Any allergies (food or environmental) or other medical information we should know about your child?
Your answer
Payment Information
Please either list credit card information or send a check to Slow Food in the Tetons, PO BOX 7290, Jackson, WY 83002. We will not store your credit card information after use.
Name on Card
Your answer
Card number
Your answer
Expiration Date
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Security Code
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Zip code for card
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Slow Food in the Tetons After School Cooking Camp- Liability/Risks Waiver
Acknowledgement, Assumption of Risks and Waiver of Claims For Minors

Please read carefully before signing. This document includes a release of liability and waiver of certain legal rights. You must fill out one for each child.

In consideration of my child being permitted to participate in cooking classes with Slow Food in the Tetons, I agree to the following provisions:

ACKNOWLEDGEMENT OF RISKS
I understand that my child will be exposed to a variety of foods and plants. I understand there are numerous inherent risks associated with participating in any gardening and cooking activities, including but not limited to using knives, operating hot stoves, boiling water, hot oil, ovens and heating elements, operating kitchen equipment, operating basic gardening tools (like shovels), cooking hazards and outdoor weather conditions and hazards. I give permission for my child to participate Slow Food in the Tetons cooking classes and in all associated gardening and cooking activities, including those described above. I acknowledge and assume the risks involved in these gardening and cooking activities and for any damage, illness and injuries that could be caused to my child from such risks. There are no physical, emotional or mental problems or limitations, including any food or other allergies, associated with my child’s participation in gardening and cooking camp activities except as disclosed by me in writing to Slow Food in the Tetons.

RELEASE, WAIVER OF LIABILITY AND INDEMNIFICATION
I, on behalf of my child, hereby release and waive any claim or prospective claim of liability by my child or by me on behalf of my child, against Slow Food in the Tetons, their employees and agents, with respect to any injuries, illness, damage or death occurring to my child while he or she participates in any and all Slow Food classes.

Parent Electronic Signature (please type your name)
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Signature Verification *
Required
Date
MM
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YYYY
Photo Release for Minors
I hereby authorize the Slow Food in the Tetons to publish photographs taken of my child for use in Slow Food printed publications, website and social media. I acknowledge that I will receive no financial compensation for photographs of my child. I release Slow Food in the Tetons, its board members, employees and agents from liability for any claims by me or any third party in connection with my participation in the above stated use of photographs of my child.
I understand that Slow Food in the Tetons is a non-profit organization and that use of photographs will be limited to educational, non-commercial purposes.
I have read and understand the above: *
Required
Parent/Guardian Signature
Your answer
Date
MM
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YYYY
Signature Verification *
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