Granny’s Saturday Morning Cooking Camp

Registration Form

Child’s Name:__________________________ sex: M F age:____ date of birth:__________

Child’s Name:__________________________ sex: M F age:____ date of birth:__________

Child’s Name:__________________________ sex: M F age:____ date of birth:__________

Children must be entering first grade in September or older.

Names of Parent(s):______________________________________________________________

Home phone #: ______________ Work phone #:____________ Cell ______________

Address: ______________________________________________________________

City_______________State ____Zip _______________

E:mail ________________________________________________________________

How did you learn about the camp? ______________________________________________________

Right to Use Photographic Likeness The undersigned grants to Granny’s Garden School the right to use and publish for educational or publicity purposes photographic likeness my child/children without identifying the child.

___________________________________________________________________________________

Signature of child’s parent or guardian  Date

I agree that by registering my child for and of Granny's Outdoor Adventure camps, I am giving permission for my child to eat a variety of garden produce and herbs. ________________________________________________________________________________

Signature of child’s parent or guardian Date

First Child $20, Each additional child is $10. Total Registration $___________________

I would like to make a donation to Granny’s Garden School $___________________

Please send a check for the total amount to, Granny's Garden School, 20 Miamiview Drive, Loveland, OH 45140.