Complete Your Personal Details Program = Students in 2nd-6th grade SSH = Student Summer Helper(12 & 13 years)SCC = Student Camp Counselor(14+) We can be a little flexible on the Student Summer Helper and Student Camp Counselor positions so please contact us at omf@OldMcDonaldsFarm.org if you have a special request. We look forward to hearing from you. We thank you in advance. Programs & WorkshopsSelected SessionNone Program SSH SCCBus Transportation Saturday One-Day Workshop: Mother/Student Equine Day - 5/18--$139(0 left)Saturday One-Day Workshop: Donkey Day - 6/15--$89(0 left)$14(0 left)Saturday One-Day Workshop: Jr. Vet. Equine (Horse) - 9/21--$99(11 left)$14(17 left)The Summer Program: Session 1, 6/24, Kirby week--$239(0 left)$160(0 left)$80(0 left)$48(5 left)The Summer Program: Session 2, 7/8, J.P. Morgan week--$239(0 left)$160(0 left)$80(0 left)$48(2 left)The Summer Program: Session 3, 7/15, Cambria week--$239(0 left)$160(0 left)$80(0 left)$48(1 left)Jr. Vet., 7/22, Baby Burro Week--$249(0 left)$160(0 left)$80(0 left)$48(3 left)The Summer Program: Session 4, 7/29, Scalloway week--$239(0 left)$160(0 left)$80(-1 left)$48(3 left)The Summer Program: Session 5, 8/5, Ruffian week--$239(0 left)$160(0 left)$80(0 left)$48(7 left)The Summer Program: Session 6, 8/12, Falabella week (DISCOUNTED) --$239(0 left)$80(-1 left)$80(0 left)$24(3 left) Parent Information Parent Name (required) Address (required) Address2 City (required) State (required) Zip(required) Day Time Phone (required) Cell Phone (required) Your Email (required) How did you hear about us (required) ---WebsiteFacebookPrint AdWord of MouthReturning Student Student Information Name (required) Age (required) Grade as of September (required) Birthdate (required) MF What is the fastest way to get in touch with you? We have your child; we must be able to reach you in an emergency. Emergency contact name (required) Please provide an emergency contact phone number (This is JUST a ten digit phone number, nothing else please.) Are there any Medical, Behavioral, Academic or Emotional concerns regarding this student that we need to be informed of to better support his or her learning? Please answer thoroughly; this information is used to ensure that your child has a successful, educational experience. If not applicable, then please type “NA.” Unless OMF obtains the container with preprinted, pharmacy instructions and a written release and instructions from you we cannot dispense any prescription medications. For nonprescription medications, we must have a written note with instructions, date and signature of parent or guardian along with original container. Please do not give any medications directly to the student to be taken while at OMF to ensure that another child does not come in contact with your medication. Your understanding is appreciated! Special behaviors of this student and/or any medications that they are taking? If not, please type in N.A. (required). General Waiver The above named student may participate in any of the programs offered this summer at Old McDonald’s Farm, Inc. (OMF, Inc.). I have the authority to act on this student’s behalf and I release OMF, Inc. and its representatives from liability in the event of accidental injury or illness. I give my permission for this student to receive emergency medical treatment. I accept full responsibility for any expense incurred in providing medical treatment for this child. I understand the inherent risks of working on a farm, in a garden, in nature, with farm animals and including working with and riding horses. I the Parent/Guardian of the aforementioned student accept the terms and conditions: Photo Release I hereby grant OMF, Inc. the right to use forever any film, video, audio, photographs, slides or combination thereof, for inclusion in any promotional or advertising purposes of OMF, Inc. and my child agrees to appear without pay. I also give my permission for my child to be interviewed, quoted and have first name only printed in media for the promotional purposes of OMF, Inc.” (Please select "do not agree" if you do not want pictures or interviews taken of this student.) Photo Releaseagreedo not agree Please be aware - we do not offer refunds.