Menu


Registration request for Cooking Class

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


Timeslot:
Thursday 11th Mar 2021, 10:00am - 11:00am
Location:
* Virtual Mtg *
Availability:
100 spaces remaining



Name:
 
Date of Birth:
Email:
Confirm email:
 
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? Yes

By clicking "Submit", you agree to send this personal information to East Wellington Family Health Team online.

You agree to the Privacy Policy, which governs how your personal information is kept safe.