Allergic to Salad's 2017 Youth Summer Culinary Experience
Dates: July 10 thru August 18
Days: Monday thru Friday
Times: 9AM to 4PM (pre- and post- care available)
Ages: 8 thru 13 years
"Base Camp": Brooklyn Society for Ethical Culture (Basement)
53 Prospect Park West, Brooklyn, NY 11215
Counselor cell phone to be provided to parents pre-start
Please complete a new registration for each child.
Contact us at Info@AllergictoSalad.com with any questions
Siblings? Complete one form per child.
PARENT/ GUARDIAN INFORMATION
Full Name (Parent/ Guardian #1) *
Your answer
Full Name (Parent/ Guardian #2)
Your answer
Street Address (where child resides) *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Email (Parent/ Guardian #1) *
Your answer
Email (Parent/ Guardian #2)
Your answer
Phone Number (Parent/ Guardian #1) *
Your answer
Phone Number (Parent/ Guardian #2)
Your answer
Alternative Phone Number *
Your answer
How did you hear about our Summer Culinary Experience? *
Required
CHILD INFORMATION
Child's First Name *
Your answer
Child's Last Name *
Your answer
Child's Gender *
Child's Birthday *
MM
/
DD
/
YYYY
Child's Age as of July 1, 2017 *
Your answer
School attending in 2017-2018 school year *
Your answer
Child's general experience / interest in cooking, gardening and investigating foods of NYC? *
Your answer
Dietary restrictions *
Required
Allergies or food intolerances *
Your answer
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