2021 NPIC - Smithfield Youth Workshop
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2021 NPIC - Smithfield Youth Workshop
Tuesday, July 13, 2021
9 a.m. - 11:30 a.m.
2021 NPIC
Kalahari Resort, Wisconsin Dells, WI

Thank you for your interest in registering for the 2021 NPIC Youth Workshop! You must complete this form for EACH child participating in the Youth Workshop.
First Name of Participant *
Last Name of Participant *
Grade that the youth participant will be entering this fall: *
Parent or Legal Guardian Name *
Parent or Legal Guardian Phone Number *
Parent or Legal Guardian Email Address *
Disclosure and Waiver
Please read carefully before signing.
I understand that a parent or legal guardian is encouraged to attend the Youth Workshop with the minor participant. Please arrive 15 minutes before the workshop to check-in and receive setup instructions.*  If a parent or legal guardian is unable to attend the Youth Workshop with the minor participant, they should be present to meet them at the end of the sessions at 11:15am in the Kilimanjaro Ballroom entrance off of the north hallway. *
Required
I, the above-named Parent/Guardian, am the parent or legal guardian of the above-named Child.  I understand there are numerous inherent risks associated with participating in any cooking/grilling activity, including, but not limited to, using sharp knives, operating a hot stove or grill, and operating and handling other kitchen/grilling equipment and tools. I further understand that participation in the cooking session includes possible exposure to and illness from infectious disease, including but not limited to COVID-19. I hereby give permission for my child to participate in all cooking/grilling activities, including those described above.  I acknowledge and assume all risks involved in participating in these cooking/grilling activities and for any damage, illness (including, without limitation, COVID-19), or injury resulting from such risks.  My child has no conditions or special needs that may limit or restrict his/her participation in the cooking/grilling lesson, except as disclosed by me in writing to Smithfield Foods. *
Required
I, on behalf of myself and my child, hereby release and waive, to the maximum extent permitted by law, any and all claims or prospective claims of liability by my child or by me on behalf of my child against Smithfield Foods, Inc. or any of its parents, subsidiaries, or affiliates and their respective employees, officers, directors or agents, with respect to any injuries, illness (including, without limitation, COVID-19), damage or death occurring to my child arising from or related to his/her participation in the 2021 NPIC Youth Workshop, including without limitation, any and all cooking/grilling activities. *
Required
I, the Parent/Guardian, assert that I have explained to my child the risks of the activity, his/her responsibilities for adhering to the rules and regulations, and that my child understands this agreement. *
Required
I, FOR MYSELF AND MY CHILD, HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT WE HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HEREBY SIGN AND AGREE TO IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. I UNDERSTAND THAT CLICKING/CHECKING HERE REPRESENTS MY SIGNATURE AND AGREEMENT TO THIS WAIVER/RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT. *
Required
Parent/Guardian Initials *
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