To register for upcoming Bay Leaf Roots Classes fill out the information below and follow instructions for payment and financial aid. If you have any problems completing your registration, please email Elianna at elianna@bayleafkitchen.org. 

Bay Leaf Roots Registration Form

Student Information
Student's Full Name *
Student's Full Name
Date of Birth
Date of Birth
(Be sure to match the date format with two digits for date and month)
Gender *
Parent Information
At least one set of parent information is required.
Parent 1
required
Parent 1 Name *
Parent 1 Name
Parent 1 Address
Parent 1 Address
Parent 1 Home Phone *
Parent 1 Home Phone
Parent 1 Cell Phone *
Parent 1 Cell Phone
Parent 2
optional
Parent 2 Name
Parent 2 Name
Parent 2 Address
Parent 2 Address
If Different than Parent 1
Parent 2 Home Phone
Parent 2 Home Phone
Parent 2 Cell Phone
Parent 2 Cell Phone
Pick-up Authorization
OPTIONAL
Name
Name
Home Phone
Home Phone
Cell Phone
Cell Phone
Emergency Contact Information
specify at least one person other than the parent
Emergency Contact 1
required
Name
Name
Home Phone
Home Phone
Cell Phone
Cell Phone
If yes, please list them here.
If so list name(s) here.
Payment Information
To pay for classes, I am: *
select one
Financial Aid
Our goal is to make our classes available to everyone. We offer full and partial financial assistance based on need. Please submit the below supplemental application to be considered. Financial Assistance applications are encouraged to apply as early as possible. Class spots are reserved on a first come first served basis and are confirmed with a $50 processing fee to hold the date.
$
Form Submission Details
please review and check the following
*
Terms
CANCELLATIONS -- Our refund policy is designed to discourage last minute cancellations and to help families on the waiting list. The class fee is refundable for requests received in writing via e-mail to amy@bayleafkitchen.org before September 14th, 2014. After September 14th, there is no refund unless the space can be filled by another student. During classes there is no refund for student illness, missed days, vacations, or dismissal from the program. Classes may be subject to change.