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Registration request for Cooking Class

Thank you for your interest in this event/program. Please complete and submit the form below.


Timeslot:
Friday 15th Nov 2019, 1:00pm - 3:00pm
Location:
HIllsburgh Wellington Cty Library, 9 Station Street Hillsburgh ON Click here for map
Availability:
6 spaces remaining



Name:
 
Date of Birth:
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Are you enrolled with one of our physicians?
How did you hear about this program?
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Important:
Food Allergies
If you have any food allergies, please provide details in the message box above.

I understand it is my responsibility to communicate my food allergies. While cooking class facilitators may take allergies into consideration, I understand that they cannot guarantee an allergy-free environment and it is up to me to decide the level of my participation.

Do you agree to the above statement? Yes

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