Summer Farm CampAges 4 -12 Located at Black Ridge Farms 1/2 a mile out of Palouse WA (25 minutes from both Pullman and Moscow)Session 1: June 10-13Session 2: June 24-27Session 3: July 8-11Cost : $240 per session MUST PAY IN FULL BEFORE SPOT CAN BE SAVED*Sibling discount 10% off total - use at checkout SIBINGDISCOUNT Parent/s Name * First Name Last Name Email * Phone * (###) ### #### What Summer Farm Camp sessions are you registering for? * (If you choose to sign up for more than one session payment will be following: Session 1: Due upon registration Session 2: Billed May 1st Session 3: Billed June 1st Session 1 - June 10-14 Session 2 - June 24-27 Session 3 - July 8-11 I would sign up for more summer camp sessions if you offered them. Your child/childrens name * Child/childrens age * Why have you chosen to register your child/children for summer farm camp 2024? Tell us briefly about your child/children. * Are you planning to stay on site or drop off? * Drop off Stay on site In case we cannot get a hold of you for emergency reasons, who can we call? * First Name Last Name Emergency phone number * (###) ### #### Who else is authorized to pick up your child? We will not allow your child to go home with any who is not authorized. A verbal authorization works too. (Example - Text, call, email and let me know name of person who is picking up.) * We like to document snippets of our days at LFNS to share with you as the parent and can be helpful for us to use for marketing the program on social media (Facebook and Instagram). Are you comfortable with photos and videos being taken of your child? Yes No photos of my child please. Does your child have any allergies? If so, what are they? * Does your child have any health concerns/conditions we need to be aware of? If any, does your child need any accommodations? * I understand in order to hold my child's spot I must also pay for camp in full upon registration. * I agree CANCELATION AND REFUND POLICY: Please allow 30 days notice before first day of session of your cancellation. You will be refunded in complete. After 30 days we cannot issue a refund unless extreme circumstances. No refunds if child misses classes due to illness or other reasons. * I agree I am aware that Little Farm Nature School is totally nature-based, is at working farm where children are allowed to get dirty and children will be outside in all weather conditions, except under severe temperatures or events. * I agree Option 2 Acknowledgement and Assumption of Risks: * 1. I understand and acknowledge that the LFNS & Black Ridge Farms programming in which the participant/my child will participate may be physically strenuous and has risks, dangers and hazards including, but not limited to: A. Hazards associated with being outdoors which may include walking/working on steep, slippery or uneven ground, exploring at the shallow river and creeks, holds, falling tree limbs or rocks, exposure to managed (grown) vegetables and unmanaged plants (those that grow in nature such as weeds, shrubs, trees, berries etc.), exposure to pollens, dusts. B. Unpredictable and changing weather that could result in exposure to sunlight, heat, cold, wet or windy weather, lightning, and animals, including dogs, deer, elk, rodents, snakes, birds, tics, insects, bees, spiders, etc. C. Hazards associated with using hand tools and equipment such as hand drills, loppers, hand-saws, mallets, wooden tent pegs, ropes, etc. D. Hazards associated with being around a wood stove E. Hazards associated with being in or around a farm. F. Hazards associated with gardening such as lifting, bending, carrying buckets of produce and using hand tools such as shovels, hoes, trowels, shears and scissors and equipment such as ladders, wheel barrels, buckets, baskets, rope, wire, gloves, etc. G. Hazards associated with having direct contact with organic materials such as composted materials, food, scraps, earth, manures, worms, etc. H. Hazards associated with becoming separated from guides or companions and in inability to communicate or access rescue and medical help. I. Theft, vandalism or loss of personal property. J. Hazards associated with farm animals, ducks, cows, sheep, rabbits, chickens, cats and dogs. K. Hazards associated with using woodworking tools, hammer, nails, manual drill and hand saw. 2. I acknowledge that participating in the LFNS program involves inherent risks and other risk hazards and dangers, including some not listed above that can cause or lead to death, injury, illness, property damage or loss, mental or emotional trauma, or disability. 3. I have been informed of my right to obtain as much information about this program activity from LFNS as I feel necessary, including information beyond that information provided to me herein respecting the nature and the extent of risks and hazards associated with the program or activity and I acknowledge that I am satisfied with the information provided to me. 4. I acknowledge that it is my responsibility to advise LFNS in writing of any health or medical concerns of my child that may affect his/her participation in the stated program or activity. If such information is not provided, I agree LFNS shall not be responsible for any adverse health or medical conditions of my child. 5. In entering into this Agreement I am not relying upon any oral or written representations or statements made by the Released Parties other than what is set forth in this Agreement. 6. I freely and voluntarily agree to assume all of the risks of the activities of my child’s Nature School program whether inherent or not and whether described above or not and understand any acknowledgement that my child, as a participant may suffer personal and potentially serious injury due to an unforeseeable or fortuitous event. I agree Release of Liability * 7. Liability Release and Indemnity Agreement. I hereby release, indemnity and hold harmless LFNS & Black Ridge Farms and each of its respective employees, officers, independent contractors, subcontractors, volunteers and all other persons or entities acting for or under the discretion and control of LFNS, Black Ridge Farms and agree to waive any and all claims that my child or I have or my spouse or other parent or successors or assigns have or may have in the future against the Released Parties for, any loss, damage, injury, claim or expense in any way associated with my child’s participation in the LFNS, Black Ridge Farms program or the use of any equipment or facilities. Neither I nor anyone acting on my or my child’s behalf will make a claim against the Released Parties as a result of injury, illness, damage, death or loss to person or property, whether arising from negligence, breach of contract or breach of any statutory or other duties of care, including any duty of care owed under the Occupiers Liability Act or similar law for the exemption of liability on public and/or recreational lands. I further agree to hold harmless and indemnify the Released Parties from any and all liability for any damage to the property or, or personal injury to any third party, including other participants in the program resulting from any child’s participation in the program. I have read this Release of Liability and Assumption of risk, fully understand its terms, understand that I have given up substantial rights by signing it and sit it freely and voluntarily without any inducement. I agree that this form shall be binding on me, my minor and/or adult children participants, my spouse or partner and other family members, my heirs, executors, representatives, successors and assigns. I hereby confirm that I have legal authority to act on my child’s behalf. I agree on my own and on my child’s behalf to the terms and conditions in this document. By selecting I AGREE below, you have read and agree with the terms outlined all above. I agree Please Sign below (Type your first and last name below) * Thank you!
