Enrolment Form Name First Last CourseRaw Food Intensive CourseRaw Food Module CourseEmail Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country PhoneWebsite Social MediaCancellation and Refund Policy Because of the intimate class size and student to instructor ratio, high standards of excellence for course curriculum, neither deposits nor enrollment fees are refundable except on a case by case basis at the discretion of Shokuiku Academy. Instead, any monies paid shall be credited towards a future course date or may be honored at our Shokuiku Cafe and in our online shop www.shokuikuastralia.com. MANNER OF REFUND: Should a refund be issued, Shokuiku Academy reserves the right to issue the refund in the manner it chooses,. If you pay the enrollment fees via credit card, you agree that you shall not be allowed to request your credit card company to “chargeback” any monies you paid to Shokuiku Academy. Consent & Release I hereby consent that Shokuiku Academy and its agents, employees, successors, and assigns may, for advertising or trade purposes, use any photograph, film, video tape or audio recording taken or recorded of me, either alone or in conjunction with photographs, films, video tapes, or audio recordings of other persons, objects, or materials. This consent includes the right to make alterations to and retouch photographs, films, and recordings. LIABILITY RELEASE This is a legally binding liability release, waiver, discharge and covenant not to sue (the “Release”), made by the undersigned, to Shokuiku Academy. I fully recognize that there are dangers and risks to which I may be exposed by participating in a culinary class or classes at Shokuiku Academy, which may involve working with culinary equipment and tools that are inherently dangerous. With full understanding of the risks involved and despite this release, I am voluntarily choosing to participate in a class or classes at Shokuiku Academy and am willing to participate in the activities associated with those endeavors. Agreement This agreement will take effect once online payment has been processed and this form has been submitted by Student; and signed and accepted by Shokuiku Academy. An email confirming enrollment will be sent via email.