Southwind Extension District is sponsoring FREE cooking classes for youth to learn more about kitchen self-care skills. The classes are for youth that have completed the second through eighth grade. Younger or older children will not be allowed.
Since this is a ‘hands-on’ experience, we limit the size of each class depending on the size of the facility. If you have questions please call Kathy McEwan at 620-365-2242 or email kmcewan@ksu.edu.
Instructors for the classes will be Nutrition Assistants Malynda Payne and Mary Daniels.
Email address *
Child’s Full Name *
Child’s Mailing Address *
Grade Just Completed *
2nd
3rd
4th
5th
6th
7th
8th
Child’s Age *
Child’s Gender
Male
Female
Primary Emergency Contact Number *
Secondary Emergency Contact Number *
Health Information (any known allergies) *
Parent’s Name *
Parent’s Email *
Parent’s Home/Cell Number/Work *
Name of Child’s Doctor *
By electronically submitting this registration form, I (parent/guardian) understand participants will be supervised and that if a serious illness or injury develops, medical and/or hospital care will be given. I hereby give permission to the attending physician to hospitalize and/or secure proper treatment for my child. I hear-by release K-State Research & Extension, the State of Kansas and their agents, officers and employees, from all claims, demands and causes of action of any kind, including claims of negligence, which may arise from participation of my minor child in “Kids In the Kitchen” classes. I also authorize K-State Research & Extension or their assignees to record and photograph my child’s image and/or voice for use in research, educational and promotional programs.
*
YES
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