Student Summer Helper – 2020

$140.00

Click Here to go to the SSH/SCC contract.

Clear

If so which day?

We have your child; we must be able to reach you in an emergency. 

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).

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 “No” if you do not want pictures or interviews taken of this student.)

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.

PLEASE NOTE WE CANNOT OFFER REFUNDS
I the Parent/Guardian of the aforementioned student accept the terms and conditions:

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