Youth Participant Class Waiver and Photo/Video Release Youth Participation Waiver and Photo/Video Release Form Culinary U Youth Participation Form & Waiver Participant Information First and Last Name * Participant Date of Birth * Does the participant have any food allergies, food sensitivities, mental or physical health conditions? If yes, please explain * Address * Address Street Address Street Address Apt./Building/Suite # Apt./Building/Suite # City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Parent/Guardian Information First and Last Name * Email Address * Mobile Phone Number to be used in case of emergency * Primary CLASS WAIVER: I understand that my child will be exposed to a variety of foods. I understand that my child will be working with cooking tools and appliances with supervision. I understand the nature of the proposed activities and hereby assume any and all risks associated with those activities. My child has my permission to participate in Culinary U of the Triad programs. By signing below I release any claims, damages and liabilities arising from or related to my child's participation in this program including possible exposure to COVID-19. Signature * Clear PHOTO/VIDEO RELEASE: I hereby authorize Culinary U of the Triad to publish photos and videos taken of my child for use on Culinary U website, Facebook page, and other promotional materials. I understand that since participation is voluntary, neither the minor child nor I will receive financial compensation. I further understand that participation in any publication or website produced by Culinary U confers no rights of ownership whatsoever. I release Culinary U from liability for any claims by me or any third party in connection with my participation or the participation of the undersigned minor children. Signature * Clear Submit Δ