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Come, join in and learn about math, science, language arts and social studies in our cooking club.

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Chefsville Kids: Birmingham Elementary Cooking Club
Letter of Permission and Consent

I would like my child to participate in the 6-week Cooking Club Program.

Club meetings are on Wednesdays from 2:35pm – 4:00pm on:

4/12, 4/19, 4/26, 5/03, 5/10 & 5/17


6-week after-school Cooking Club $90 + $5 online fee

Payment options: Full payment or 2 payments of $71.75 spaced 4 weeks apart or 3 payments of $48 spaced 3 weeks apart.

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 risks of these and other medical issues. Also students will learn how their body digests food and connects to their senses. Please see Chef Scott immediately if parents are sensitive about these topics. As young students may only pick up part of this information there will be no refunds allowed if parents have sensitivity to these topics and decide to not communicate with Chef Scott or decide to withdraw their child from the program without advising of any sensitivity to these topics.

Gathering Health Information on Participant: I understand that during the course of participating in the Chefsville Kids’ programming that 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 the PTA or Parks and Recreation and/or those 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) being 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. 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 my signature on this Liability Waiver, I bind my heirs, and current or future representatives, and myself to the terms and conditions of this Liability Waiver.