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Emergency and Permission Form

Please fill out a separate emergency form for each child.

* indicates required field

Medical and Emergency Information

If your child needs to take medication while at the farm, please bring it in the original bottle with specific directions for administering.

In case of an emergency we will always try to contact parents/guardians first. Should we be unable to reach you, please give us the names and phone numbers of two other people we should be able to reach during the hours your child is at the farm (8:00am-6:00pm):

Please list the first and last names and phone numbers of everyone who has permission to pick up your camper, including yourself. Anyone picking up for the first time should be prepared to show a photo ID.

I certify that the above information is correct

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