Name of Event Your Chef is Attending (Ex: Troop 700 Badge Class)

Child's Full Name

Child's Date of Birth

Parent or Guardian Name

Email Address

Emergency Contact Number

Child's Dietary Preferences, Allergies & Severity - If any dietary preferences/ allergies, please indicate the severity of each one. For example, is contact with the allergen ok? Are ingredients processed on equipment or in a facility shared with the allergen ok?

COVID WAIVER & DISCLAIMER: Kidinary Academy and it’s staff will follow all health and safety guidelines put forth by Illinois specifically the Village of Plainfield kids , including but not limited to daily symptom screening of staff and participants via entering the building, social distancing , supervising hand-washing and sanitizing, cleaning and disinfecting all surfaces between programs, and not allowing family-style serving). I confirm I will screen my child prior to coming to each class at Kidinary Academy and if they exhibit any symptoms of COVID-19, they will not attend class. I understand that if my child exhibits any COVID-19 symptoms during class screening they will be unable to attend class (and I will not be entitled to any refunds or credits). I also understand that I am allowing my child to attend cooking class during a time where COVID-19 is prevalent. I accept these risks and will not hold Kidinary Cooking (or their staff) liable for any injury or illness for classes are non-refundable and due to limited class sizes as a result of COVID-19 and we are reserving a spot for your child when you register, and unfortunately we cannot offer make-ups for missed classes. I confirm that masks are OPTIONAL to wear during class to my family's discretion. I also acknowledge that if my child un-enrolls, cancel, or miss class for any reason, that I am not entitled to any refunds, credits, or make-up classes (as make-up classes are not offered). COVID WAIVER & DISCLAIMER: Kidinary Academy and it’s staff will follow all health and safety guidelines put forth by Illinois specifically the Village of Plainfield kids , including but not limited to daily symptom screening of staff and participants via entering the building, social distancing , supervising hand-washing and sanitizing, cleaning and disinfecting all surfaces between programs, and not allowing family-style serving). I confirm I will screen my child prior to coming to each class at Kidinary Academy and if they exhibit any symptoms of COVID-19, they will not attend class. I understand that if my child exhibits any COVID-19 symptoms during class screening they will be unable to attend class (and I will not be entitled to any refunds or credits). I also understand that I am allowing my child to attend cooking class during a time where COVID-19 is prevalent. I accept these risks and will not hold Kidinary Cooking (or their staff) liable for any injury or illness for classes are non-refundable and due to limited class sizes as a result of COVID-19 and we are reserving a spot for your child when you register, and unfortunately we cannot offer make-ups for missed classes. I confirm that masks are OPTIONAL to wear during class to my family's discretion. I also acknowledge that if my child un-enrolls, cancel, or miss class for any reason, that I am not entitled to any refunds, credits, or make-up classes (as make-up classes are not offered).

ACCIDENT WAIVER & RELEASE OF LIABILITY FORM I HEREBY ASSUME ALL OF THE RISKS FOR MY CHILD(s) OF PARTICIPATING IN THIS ACTIVITY, including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault. I certify that there are no health-related reasons or problems, which preclude my child (s) participation in this activity. I acknowledge that this Accident Waiver and Release of Liability Form will be used by the event holders, sponsors, and organizers of the activity in which my child(s) may participate, and that it will govern my child(s)’ actions and responsibilities at said activity. In consideration of my application and permitting my child(s) to participate in this activity, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my child(s) death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to my child (s) from this activity. I acknowledge that Kidinary Academy and their directors, officers, volunteers, representatives, and agents are NOT responsible for the errors, omissions, acts, or failures to act of any party or entity conducting a specific activity on their behalf. I acknowledge that this activity may involve certain risks and carries with it the potential for death, serious injury, and property loss. The risks include, but are not limited to, those caused by trade tools, facilities and actions of other people including, but not limited to, participants, volunteers, monitors, and/or producers of the activity. These risks are not only inherent to participants but are also present for volunteers. I hereby consent my child(s) to receive medical treatment that may be deemed advisable in the event of injury, accident, and/or illness during this activity. The Accident Waiver and Release of Liability Form shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. COVID WAIVER & DISCLAIMER: Kidinary Academy and it’s staff will follow all health and safety guidelines put forth by Illinois specifically the Village of Plainfield (including, but not limited to, limiting class size to 10 participants, requiring all staff, kids and parents to wear face coverings during class (except while eating), daily symptom screening of staff and participants via entering the building (including but not limited to temperature screenings), maintaining social distancing, supervising hand-washing and sanitizing, cleaning and disinfecting all surfaces between programs, and not allowing family-style serving, or the sharing of tools or equipment). I confirm I will screen my child prior to coming to each class at Kidinary Academy and if they exhibit any symptoms of COVID-19, they will not attend class. I understand that if my child exhibits any COVID-19 symptoms during class screening they will be unable to attend class (and I will not be entitled to any refunds or credits). I also understand that I am allowing my child to attend cooking class during a time where COVID-19 is prevalent. I accept these risks and will not hold Kidinary Academy (or their staff) liable for any injury or illness. I confirm I will bring a face covering for my child (face mask or face shield) to wear during class. I understand that my child will be required to follow all the instructions of Kidinary Academy staff (including, but not limited to, wearing their face covering, maintaining social distancing, hand-washing, not sharing tools), and that if my child is unable or unwilling to do so, they will not be allowed to participate in class (and I will not be entitled to any refunds or credits). I also acknowledge that is a unenroll, cancel, or miss class for any reason, that I am not entitled to any refunds, credits, or make-up classes (as make-up classes are not offered). FOOD ALLERGY DISCLAIMER- ACKNOWLEDGEMENT OF RISKS I understand that my child will be exposed to a variety of foods. I understand there are inherent risks associated with participating in any cooking activities using various cooking tools and operating kitchen appliance with supervision. I give permission for my child to participate in all cooking activities, including those described above. I acknowledge and assume all risks associated with these cooking activities and for any damage, illness, and injuries resulting from such risks. There are no physical, emotional or mental problems or limitations associated with my child’s participation in cooking activities except as disclosed by me in writing to Kidinary Academy. Kidinary Academy makes every attempt to identify all ingredients in their recipes. Every effort is made to instruct our certified cooking instructors on the severity of food allergies. In addition, we label recipes with possible allergen-containing ingredients; however, there is always a risk of contamination. You must make the decision of enrolling your child based on this information and the possible health risk. There is also a possibility that manufacturers of the commercial foods we use could change the formulation at any time, without notice. Customers concerned with food allergies need to be aware of this risk. Kidinary Academy will not assume any liability for adverse reactions to food consumed, or items one may come in contact with while participating in any Kidinary Academy Cooking Course. I understand that every attempt will be made to eliminate exposure and risk to my child, but agree that Kidinary Academy or it’s instructors assumes no liability for adverse reactions for food consumed or items that my child may come in contact with while participating in courses. PARENT OR GUARDIAN “MODEL” RELEASE FOR CHILD I am the parent or guardian of the minor child named below and I have the legal authority to execute this release on behalf of the child. In consideration of the child’s engagement as a model and for other valuable consideration received, I give Kidinary Academy, the Company, and Instructors (“Photographer and or Videographer”) and Photographer’s / Videographer heirs, legal representatives, and assigns the irrevocable, perpetual, and unrestricted right to take and use photographs of the child(s) named below taken by the Photographer /Videographer (“Photographs / Videos ”) in all forms, media and manners, in conjunction with the child’s or a fictitious name, for advertising, trade, promotion, exhibition, or any other lawful purposes. I waive any right to review or approve the Photographs / Videos, the use of the Photographs / Videos, or the matter that may be used in conjunction with the Photographs / Videos now and in the future, regardless of whether that use or matter is known to me. I waive any right to royalties or other compensation arising from or related to the use of the Photographs / Videos. I release, discharge, and agree to hold harmless Photographer / Videographer and Photographer’s / Videographer’s heirs, legal representatives, and assigns from any liability by virtue of any blurring, distortion, alteration, optical illusion, or use in composite form, whether intentional or otherwise, that may occur or be produced in the taking, processing, or publication of the Photographs / Videos . This release shall be binding upon me and my heirs, legal representatives, and assigns. I CERTIFY THAT I HAVE READ THIS DOCUMENT AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN FREE WILL. ACCIDENT WAIVER & RELEASE OF LIABILITY FORM I HEREBY ASSUME ALL OF THE RISKS FOR MY CHILD(s) OF PARTICIPATING IN THIS ACTIVITY, including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault. I certify that there are no health-related reasons or problems, which preclude my child (s) participation in this activity. I acknowledge that this Accident Waiver and Release of Liability Form will be used by the event holders, sponsors, and organizers of the activity in which my child(s) may participate, and that it will govern my child(s)’ actions and responsibilities at said activity. In consideration of my application and permitting my child(s) to participate in this activity, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my child(s) death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to my child (s) from this activity. I acknowledge that Kidinary Academy and their directors, officers, volunteers, representatives, and agents are NOT responsible for the errors, omissions, acts, or failures to act of any party or entity conducting a specific activity on their behalf. I acknowledge that this activity may involve certain risks and carries with it the potential for death, serious injury, and property loss. The risks include, but are not limited to, those caused by trade tools, facilities and actions of other people including, but not limited to, participants, volunteers, monitors, and/or producers of the activity. These risks are not only inherent to participants but are also present for volunteers. I hereby consent my child(s) to receive medical treatment that may be deemed advisable in the event of injury, accident, and/or illness during this activity. The Accident Waiver and Release of Liability Form shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. COVID WAIVER & DISCLAIMER: Kidinary Academy and it’s staff will follow all health and safety guidelines put forth by Illinois specifically the Village of Plainfield (including, but not limited to, limiting class size to 10 participants, requiring all staff, kids and parents to wear face coverings during class (except while eating), daily symptom screening of staff and participants via entering the building (including but not limited to temperature screenings), maintaining social distancing, supervising hand-washing and sanitizing, cleaning and disinfecting all surfaces between programs, and not allowing family-style serving, or the sharing of tools or equipment). I confirm I will screen my child prior to coming to each class at Kidinary Academy and if they exhibit any symptoms of COVID-19, they will not attend class. I understand that if my child exhibits any COVID-19 symptoms during class screening they will be unable to attend class (and I will not be entitled to any refunds or credits). I also understand that I am allowing my child to attend cooking class during a time where COVID-19 is prevalent. I accept these risks and will not hold Kidinary Academy (or their staff) liable for any injury or illness. I confirm I will bring a face covering for my child (face mask or face shield) to wear during class. I understand that my child will be required to follow all the instructions of Kidinary Academy staff (including, but not limited to, wearing their face covering, maintaining social distancing, hand-washing, not sharing tools), and that if my child is unable or unwilling to do so, they will not be allowed to participate in class (and I will not be entitled to any refunds or credits). I also acknowledge that is a unenroll, cancel, or miss class for any reason, that I am not entitled to any refunds, credits, or make-up classes (as make-up classes are not offered). FOOD ALLERGY DISCLAIMER- ACKNOWLEDGEMENT OF RISKS I understand that my child will be exposed to a variety of foods. I understand there are inherent risks associated with participating in any cooking activities using various cooking tools and operating kitchen appliance with supervision. I give permission for my child to participate in all cooking activities, including those described above. I acknowledge and assume all risks associated with these cooking activities and for any damage, illness, and injuries resulting from such risks. There are no physical, emotional or mental problems or limitations associated with my child’s participation in cooking activities except as disclosed by me in writing to Kidinary Academy. Kidinary Academy makes every attempt to identify all ingredients in their recipes. Every effort is made to instruct our certified cooking instructors on the severity of food allergies. In addition, we label recipes with possible allergen-containing ingredients; however, there is always a risk of contamination. You must make the decision of enrolling your child based on this information and the possible health risk. There is also a possibility that manufacturers of the commercial foods we use could change the formulation at any time, without notice. Customers concerned with food allergies need to be aware of this risk. Kidinary Academy will not assume any liability for adverse reactions to food consumed, or items one may come in contact with while participating in any Kidinary Academy Cooking Course. I understand that every attempt will be made to eliminate exposure and risk to my child, but agree that Kidinary Academy or it’s instructors assumes no liability for adverse reactions for food consumed or items that my child may come in contact with while participating in courses. PARENT OR GUARDIAN “MODEL” RELEASE FOR CHILD I am the parent or guardian of the minor child named below and I have the legal authority to execute this release on behalf of the child. In consideration of the child’s engagement as a model and for other valuable consideration received, I give Kidinary Academy, the Company, and Instructors (“Photographer and or Videographer”) and Photographer’s / Videographer heirs, legal representatives, and assigns the irrevocable, perpetual, and unrestricted right to take and use photographs of the child(s) named below taken by the Photographer /Videographer (“Photographs / Videos ”) in all forms, media and manners, in conjunction with the child’s or a fictitious name, for advertising, trade, promotion, exhibition, or any other lawful purposes. I waive any right to review or approve the Photographs / Videos, the use of the Photographs / Videos, or the matter that may be used in conjunction with the Photographs / Videos now and in the future, regardless of whether that use or matter is known to me. I waive any right to royalties or other compensation arising from or related to the use of the Photographs / Videos. I release, discharge, and agree to hold harmless Photographer / Videographer and Photographer’s / Videographer’s heirs, legal representatives, and assigns from any liability by virtue of any blurring, distortion, alteration, optical illusion, or use in composite form, whether intentional or otherwise, that may occur or be produced in the taking, processing, or publication of the Photographs / Videos . This release shall be binding upon me and my heirs, legal representatives, and assigns. I CERTIFY THAT I HAVE READ THIS DOCUMENT AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN FREE WILL. Yes, I have read and agree to the terms & COVID Waiver & Disclaimer above. --- REQUIRED