Student Name *

First Name

Last Name

Student Date of Birth *

MM

DD

YYYY

Student's Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent/ Guardian Contact *

First Name

Last Name

Parent/ Guardian Contact Phone *

(###)

###

####

Additional Emergency Contact *

First Name

Last Name

Additional Emergency Contact 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. *

I give consent

I do NOT give consent (please complete next question)

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. *

Consent

Deny Consent

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. *

Yes, I agree & give consent for myself/ my child/ my ward

At Fun-E Farm we strive for an atmosphere of peace, courtesy, kindness and respect. Children and adults alike are treated with respect. Children will be shown how to work through conflict using communication, taking personal responsibility and offering empathy. Clear ground rules will be established at the start of each session so that children know the expectations for their behavior. Alongside academic learning, we will focus on children becoming responsible, respectful and resourceful members of their community. To be a successful, contributing member of their community students must learn necessary social and life skills. Staff will model grace, courtesy, respect, and problem solving skills throughout their daily activities. Violence or bullying will not be tolerated. Bullying is defined as repeated acts by one or more students causing harm to another. Acts may be written, verbal, physical, or any combination thereof. Bullying is ongoing by nature and is a conscious desire to hurt, embarrass, exclude or upset another. *

I agree to this policy

Please select your tuition payment schedule *

3 Equal Payments due Aug 30, Dec 14 & April 24, 2024

Full Payment for all 3 sessions due August 30, 2024

Please select your payment method *

On-line credit card payment (additional processing fee)

Check (mailed to the farm or dropped off in person)

Cash (dropped off in person)

Do you have multiple children registering? *

Sibling Discount Information 1st child full tuition, each additional child 10% discount

Yes

No

Early Drop-Off will be offered a-la-carte from 8AM - 8:45AM. Cost: $20/day cash or check (due at the time of drop off). Will you need to utilize this service during the year? *

Yes

No