Farm Camp Registration

Camp Information

Welcome to Farm Camp! We're excited to offer this unique learning experience for your child.

Started in 2015, this award-winning program provides hands-on learning experiences for kids, utilizing resources from the Agriculture in the Classroom program. We hire college students with an interest in teaching kids about agriculture to coordinate the camps. Combine these resources with field trips to different farms and you get a well-rounded learning experience. Shear sheep, milk a cow, drive a tractor… our campers have done it!
- Camps will be Monday - Thursday
- Hours each day will be 9am to 12am
- Camps will be limited to 20 kids
- Camp is for kids 6-9 years old
- Includes field trips to local farms
FARM CAMP LOCATIONS
- Prophetstown: June 16-19
- Fulton: July 14-17
- Morrison: July 21-23, 25
- Rock Falls: July 28-31
REGISTRATION FEE
The Farm Camp fee is $30 per child. Fee must be paid prior to the start of each camp to reserve your child's spot. Registration for all camps is taken on a first-come, first-serve basis. The deadline to register is one week prior to the start of each camp.

QUESTIONS?

Contact Matt Lillpop with Whiteside County Farm Bureau

(815) 441-8572 (call/text) | matt.wcfb@gmail.com
Online payment option available at end of registration form.

Checks can be made payable to and mailed to:

Whiteside County Farm Bureau Foundation

100 East Knox Street

Morrison, IL 61270

Camp Selection
My child(ren) would like to attend:*

Prophetstown: June 16-19Fulton: July 14-17Morrison: July 21-23, 25Rock Falls: July 28-31
Child Information
Name: Child #1*

First NameLast NameSuffix
Birth Date: Child #1*

MonthDayYear
Gender: Child #1*

MaleFemalePrefer not to disclose
I am registering another child:*

YesNo

Name: Child #2

First NameLast NameSuffix
Birth Date: Child #2

MonthDayYear
Gender: Child #2

MaleFemalePrefer not to disclose
I am registering another child:

YesNo

Name: Child #3

First NameLast NameSuffix
Birth Date: Child #3

MonthDayYear
Gender: Child #3

MaleFemalePrefer not to disclose
I am registering another child:

YesNo

Name: Child #4

First NameLast NameSuffix
Birth Date: Child #4

MonthDayYear
Gender: Child #4

MaleFemalePrefer not to disclose

Parent/Guardian Information
Name*

First NameLast Name
The parent/guardian is the emergency contact:*
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Preferred Phone Number*
You can text me at this number:*

YesNo
E-mail*

Emergency Contact Information
Emergency Contact's Name

First NameLast Name
Relationship
Phone Number

Medical Information
Does the child have any allergies, chronic illnesses, or medical conditions? If yes, please describe.*
Does the child need to take prescribed medication during camp or carry an inhaler? If yes, please explain instructions.*

Participant Waiver

This Participant Waiver executed on the date below by the below signee ("Participant") releases Whiteside County Farm Bureau, a nonprofit corporation organized and existing under the laws of the State of Illinois and each of its directors, officers, employees and agents (collectively "Farm Bureau"). The Participant desires to attend Junior Vet University ("Activity") hosted by Farm Bureau and participate in the Activity. I hereby voluntarily execute this Participant Waiver under the following terms:

Waiver and Release: I, the Participant, release and forever discharge and hold harmless Farm Bureau, its officers, directors, agents and emplyees and its successors and assigns from any and all liability, claims, and demands of whatever kind of nature, either in law or in equity, which arise or may hereafter arise from Activity attendance and participation. I understand and acknowledge that this release discharges Farm Bureau from any liability or claim that I may have again Farm Bureau with respect to bodily injury, personal injury, illness, death, or property damage that may result from Activity attendance or occurring while I am participating in the Activity.

Photographic Release: I grant and convey to Farm Bureau all right, title, and interests in any and all photographs, images, video, or audio recordings of me or my likeness or voice made by Farm Bureau in connection with my Activity attendance and participation.

Other: As a Participant, I expressly agree that this release is intended to be as board and inclusive as permitted by the laws of the State of Illiois and that this release shall be governed by and interpreted in accordance with the laws of the State of Illinois. I agree that in the event that any clause or provision of this release is deemed invalid, the enforceability of the remaining provisions of this release shall not be affected.
Parent/Guardian Signature*

Clear
Date*

MonthDayYear
Date

REGISTRATION FEE

Registration fee is $30 per child.

CREDIT/DEBIT CARD: Click the yellow PayPal button and check out as a guest

CHECK: Make check payable to and send to Whiteside County Farm Bureau Foundation 100 East Knox Street, Morrison, IL 61270

Registration fee must be paid prior to the start of camp
My Products
prevnext( X )
Farm Camp Registration$30.00
Check box to check out

Quantity

Total $0.00

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Should be Empty: