Camper Name *
Camper Name
Camper Date of Birth *
Camper Date of Birth
Camper's Address *
Camper's Address
Camper's Previous Riding Experience *
How did you hear about us? *
Emergency Contact *
Emergency Contact
Emergency Contact Cell Phone *
Emergency Contact Cell Phone
Emergency Contact Home Phone *
Emergency Contact Home Phone
In the event emergency medical aide/ treatment is required due to illness or injury during the process of receiving services, or while being on the property of Fun-E Farm T.O.O., I authorize Fun-E Farm T.O.O. to secure and retain medical treatment and transportation if needed. I release participant records upon request to the authorized individual or agency involved in the medical emergency treatment at my expense. I hold Fun-E Farm T.O.O. harmless for any expenses incurred in my interests. *
Camp Session Selection *
Please note, our only available session is Week 5 Clinic Camp for participants 11+. All other sessions are FULL as of June 11.
Payment Method *
Media release for all promotional materials (including but not limited to) photographs, audio/videos, testimonials for our use on our website or Facebook/ Instagram page and/or for print. By selecting "consent" below, you are hereby authorizing the use and reproduction by Fun-E Farm T.O.O. of any and all audio/visual materials taken of me/ my child/ my ward for promotional material, education activities, website, or for anyother use for the benefit of the program. *
I would like to participate in Fun-E Farm T.O.O.’s farm programs. I acknowledge the risks and potential risks of being around horses and on a farm. However, I feel that the possible benefit to myself/ my child/ my ward are greater than the risk assumed. I hereby, intending to be legally bound, for myself, my heirs and assigns, executors or administrators, waive and release forever all claims for damages against Fun-E Farm T.O.O., Fun-E Farm Inc., FEF LLC, its owners, instructors, therapists, consultants, volunteers and/or employees for any and all injuries and/or losses I/ my child/ my ward may sustain while participating in Fun-E Farm T.O.O.’s programs. *