Expanding Horizons Farm Non-Summer Camp Form

Expanding Horizons Farm

2024
Welcome to the Expanding Horizons Farm Registration and Liability Form!

Please complete the application and waiver of liability electronically or print it off and mail it to the address at the bottom. Parent/Guardian must complete waivers for their children. All attached forms must be completed before your participant can attend any events. These include the registration form, medical release form, waiver and release of liability form for each of the facilities.

Expanding Horizons Farm (a mobile ministry) has every intention to be a safe and fun environment. We anticipate lots of running, playing, and hanging out with animals - depending on the clinic or event you participate in. That being said please be sure to send your child with CLOSED TOE SHOES (boots are best), weather and activity appropriate clothing, and water. We will not be able to provide any additional resources at clinics and events. At EHF we are sensitive to allergies that others may have and so please note any specifications below and also be aware of others. We will alert you if there is a known allergen present. If you have any questions please feel free to call us at 970.658.6281.

Payments/donations can be made via PayPal, mailed check, our donations website, or through Venmo.

Please make checks payable to Expanding Horizons Farm. 501c3 EIN:82-1569448

Please reach out if you have any questions, I look forward to seeing you soon!

Emma Englesby

970.658.6281

P.O. Box 272923

Fort Collins, CO 80527

Thank you!

Expanding Horizons Farm
Name of Participant (Parent name or kiddo)
Registering For
Age
Address
City
State
Zip Code
Email
example@example.com
How did you hear about us?
Is this your first visit?
Emergency Contact

(Must be a parent or guardian)
Name*
Relationship*
Phone Number*
If you cant be reached who should we call
Name
Relationship
Phone Number
Authorized Pick-up Personnel (if applicable)

We do not anticipate parents leaving during clinics or events, but should you require another person to pick up your child in case of emergency, please indicate who that would be.
Name 1
Phone 1
Name 2
Phone 2
Medical Information
Allergies
Food*
Medications*
Other (bees, latex, etc)*
Is an Epi-pen required for allergies?*
Please indicate any special needs so we can joyfully accomodate!
Mobility
Dietary (Vegetarian, Vegan, etc)
Learning
Disease or Disorder
Please list anyhing else you think would be helpful so that we can make the days most enjoyable!
RELEASE OF LIABILITY

I hereby release and hold harmless Expanding Horizons Farm, its employees, volunteers, animals, and facility and assign from all liability for personal injury, including death, as well as all property damage or loss arising out of my/my child’s participation in this Camp Program. I understand that this release and indemnification releases liability for the conduct of Expanding Horizons Farm and its employees, volunteers, animals, and facility.
Signature (parent or guardian)*
Date*
PHOTO RELEASE

The undersigned gives permission to Expanding Horizons Farm to use photographs and audio and/or video recordings of the Participant for fundraising and/or marketing purposes. On occasion, with this signed permission, Participant photographs may be included in promotional videos, websites, End of Year albums, newsletters or our Information Handouts. Expanding Horizons Farm respects the privacy of its participants and does not allow unauthorized visitors to photograph or video the camp or its Participants.
Signature (parent or guardian)
Date
PARTICIPATION CONSENT

The undersigned gives participant permission to participate in any and all activities, except those specifically prohibited by parent or physician.
Signature (parent or guardian)*
Date*
Prayer Requests
Sibling Registrations

Don't bother filling out another full registration form! If your kiddos will be attending the same event or clinic just add their name to this registration form. If there are any special notes for the addition child, ESPECIALLY ALLERGIES** please note them below their Name and age.
Name

First NameLast Name
Age
Notes*
Name

First NameLast Name
Age
Notes*
Name

First NameLast Name
Age
Notes*
Should be Empty:

Expanding Horizons Farm

Authorized Pick-up Personnel (if applicable)

Sibling Registrations