Children’s Registration Form

Children’s Registration Form

Registration Form

Fill out the form carefully for registration
Who is Your Sales Consultant*
Student Name*

First NameLast NameReferral Code
Birth Date

MonthDayYear
Gender
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent E-mail*
example@example.com
Parent Phone Number*
Parent’s Name*

Dietary Restrictions
What is your child's appatite?
List your child's allergies - if any
What are your child's likes & disliskes?
Additional Information

My Products*
prevnext( X )
Option ARubbermaid Parfait Set (1 Cup, 1 Lid, 1 Insert) x 2 Rubbermaid Lunch Set (1 Container, 1 Lid) x 5 Rubbermaid Breakfast Set (1 Container, 1 Lid) x 5 Rubbermaid Snack Set (1 Container, 1 Lid) x 5 Sistema Sauce Cup (1 Container, 1 Lid) x 10 Ziploc Extra Small Pudding Cup (1 Container, 1 Lid) x 5
$80.00 Quantity
Item subtotal:$0.00



Option BRubbermaid Parfait Set (1 Cup, 1 Lid, 1 Insert) x 2 Rubbermaid Lunch Set (1 Container, 1 Lid) x 5 Rubbermaid Breakfast Set (1 Container, 1 Lid) x 5 Rubbermaid Snack Set (1 Container, 1 Lid) x 5 Sistema Sauce Cup (1 Container, 1 Lid) x 10 Ziploc Extra Small Pudding Cup (1 Container, 1 Lid) x 5 2 Thermos
$105.00 Quantity
Item subtotal:$0.00



Lunch Kit
$35.00 Quantity
Item subtotal:$0.00



Total

$0.00

Thank you!

Please send e-transfer payment to CooksForKids2023@gmail.com (Password - Sunshine)
Please be advised: there is a 30 day cancellation policy - you MUST give 30 days notice for any cancellations made to your subscription. NEW CLIENTS in their FIRST MONTH ONLY, require a minimum of 2 weeks.
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