After-School Terms/Disclosure Agreement

Sensitive program health and nutrition topics: This program educates about high blood pressure, diabetes, heart disease and high cholesterol. Discussion points include how the medical industry prescribes medication and how eating foods will help lower the risks of these and other medical issues. In addition, students will learn how their body digests food and connects to their senses. Please see the instructor immediately if topics are sensitive. As students may only pick up part of this information there will be no refunds allowed once the program has started.

Gathering Health Information on Participant: I understand that during the course of participating in the Chefsville Kids programming personal health information about my child may be collected as permitted for the purposes of (a) Identifying known food allergies, intolerances, dietary restrictions and medical conditions and contact information for the family doctor, should it be necessary; and (b) planning, monitoring and evaluating this program. I consent to the collection, use, and sharing of personal health information about my child by the staff and volunteers of Chefsville. I understand that statistics about this program may be included in annual reports to the community published by Public Health Services, as required or permitted by law. I acknowledge that I have read and understand this consent and that I may withhold my consent or withdraw my consent at any time by providing written notice.

Media pictures and videos release: I further give consent allowing myself and/or my child(ren) to be in pictures and videos used to promote this program without pay to me. The pictures or videos may be taken and used without my knowledge or payment to me or my heirs, and current or future representatives. 

Liability Waiver and Release: I also waive any claim against Chefsville, their agents, servants, insurers and employees, and hereby release them from any claim, cause of action or demand I may have arising out of or in connection with any personal injury or bodily injury, death or property damage which I, my child, my children, those children under my care and direction, may sustain during the Program. The Program, not licensed by Texas, may meet in a Licensed or exempt facility. Cooking in nature can be a dangerous activity. This indemnification shall include, but not be limited to liability settlements, damage awards, costs, and attorney’s fees associated with any such claims.  By registering my child/children, I agree to the terms on this Liability Waiver, I bind my heirs, current or future representatives, and myself to the terms and conditions of this Liability Waiver.

Cancellation prior to the program start date shall be refunded less $75. No refunds after the program starts.

Successful registration means that the client agrees to all of these disclosed conditions.