Child's Name *

First Name

Last Name

Child's Preferred Pronouns *

She/her

He/his

They/them

Child's Birthdate *

MM

DD

YYYY

Additional Child's Name

If registering more than one from the same family.

First Name

Last Name

Additional Child's Preferred Pronouns

She/her

He/him

They/them

Additional Child's Birthdate

MM

DD

YYYY

Parent's Name (1) *

First Name

Last Name

Parent's Name (2)

Optional

First Name

Last Name

Non-Emergency Number for Pics and Routine Camp Business *

Enter the number we should text or call if we need to reach you re registration/paperwork, pickup/dropoff confirmations or other routine matters. We'll also send occasional pics from camp to this number :)

(###)

###

####

Emergency Contact *

The name of the person we should contact in case of an emergency during camp

First Name

Last Name

Emergency Phone Number *

The number we should call in case of an emergency during camp

(###)

###

####

Any food allergies or restrictions on food for any reason? *

At Adventure Kitchen, eating and cooking are a fun adventure! Kids are encouraged, but never forced, to try new things. If there is anything we should NOT encourage your child to consume, we need to know!

No restrictions

Some restrictions

We Take Pictures and Video During Camp! *

We take pictures and video during camp and we share these on our website and social media. If you are uncomfortable with this, please contact Lynley Jones at lynley@adventurekitchen.com to request your child not appear in these.

I understand and will contact Lynley Jones if I want to request my child not appear in photos and video.

We Expect the Best of Our Kids! *

At Adventure Kitchen, we are honest and respectful, and expect all our kids to be as well. We will carefully explain all rules and expectations. If for any reason your child is unable or unwilling to follow the rules, we'll speak to them and we may ask them to sit out during an activity. If there are repeated problems with an individual child that we're not able to manage, we may contact the parents to request that the child leave the camp. This helps all the kids enjoy the experience and keeps everyone safe. If this occurs, your tuition will not be refunded. Please explain this to your child, and check the box to let us know you have.

I understand, and I've explained this to my child(ren)

Name of Parent or Guardian Completing This Form *

First Name

Last Name