Registration request for Cooking Class

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

Timeslot:

Friday 6th Dec 2019, 7:00pm - 7:00pm

Location:

FHT Office

Full Legal Name:

Date of Birth:

Email:

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Phone Number:

Are you enrolled with one of our physicians?

How did you hear about this program?

Message:

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(s)? Yes

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