Student Information Form - Home Chef School

1 Student Information

2 Parent/Guardian Information

3 Release of Liability

Student Data Form
To be completed by parent or guardian prior to the start date, one per registration. Please arrive 10-15 minutes early to complete this form on-site OR print at home and fill it out prior to class start date. Participants will not be permitted in the learning kitchen until this has been completed and submitted.

If you have registered more than one student, please complete Step 1 and Step 3 on each form; Step 2 can be shared for several registrations if the forms are submitted and kept attached.
Student Information
First & Last Name*
First Last
Birth Date*
Date Format: MM slash DD slash YYYY
Age*
Registered for (Months/Day)*
Example: July 5-10
Choose One*
- Morning Class (9am-12pm)
- Afternoon Class (1pm-4pm)
- Full Day (9am-4pm)
Please Check All That Apply*
- Allergy & Dietary Restrictions
- Physical Limitations & Restrictions
- Medical Disorders & Illnesses
- None
Please describe allergies/restrictions.*
Please describe any physical limitations or restrictions.*
Please describe any medical disorders or illnesses.*
Additional Information
Please put comments, questions, or additional information here.

Parent/Guardian Information
First & Last Name*
First Last
Relation to Student*
Email Address*
Cell Phone*
Alternate Phone
Secondary Contact
First & Last Name*
First Last
Relation to Student*
Cell Phone*
Alternate Phone

Release of Liability
To the best of my knowledge, the above information is complete and accurate. I understand that The Culinary Arts School of Ontario Ltd. Is not responsible for childcare services outside of the allocated timeframes for their recreational programs; I will have safe drop-off and pick-up arrangements for my student(s) registered at the Home Chef School.

In consideration of the acceptance of the undersigned’s application for enrolment as a student at Home Chef School, part of The Culinary Arts School of Ontario Ltd., the undersigned hereby releases and forever discharges The Culinary Arts School of Ontario Ltd. and Culinaria Restaurant & Events, its shareholders, officers, directors, employees, agents and contractors and their respective heirs, executors, administrators, successors and assigns (the “released Parties”) from and against any and all claims, suits, actions and demands that the undersigned and his or her heirs, executors, administrators, successors and assigns may at any time have against any one or more of the Released Parties and their respective heirs, executors, administrators, successors and assigns in respect to any loss of or damage to property, personal injury or death that the undersigned may suffer or incur while completing the undersigns course of study at the premises of The Culinary Arts School of Ontario Ltd. or elsewhere.

The undersigned further agrees that the undersigned will not make any claims (expressly including any crossclaim, counterclaim, third party action or application) against any person, firm or corporation who might claim contribution and indemnify against the persons or corporation discharged by this Release.
Date*
Date Format: MM slash DD slash YYYY
Please type your full name to aknowledge you've read and accepted the liability disclaimer above

Student Data Form

Student Information

Parent/Guardian Information

Secondary Contact

Release of Liability

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