Group Visit Request Form

Group Visit Request Form
Please complete this form to request a visit to Wasatch Community Gardens. You will be contacted to confirm booking after submitting the form.
Name

First NameLast Name
Email
example@example.com
Organization Name:

Group Interest Information:

Each group visit is one and a half to two hours long and includes a guided garden tour, a snack, and an activity tailored to your group's interests. Our activities and snacks change with the seasons. Visit content will be adjusted for your group's age level.
Please select the topic your group would be most interested in learning about. If your group has a specific interest (e.g. a particular Girl Scout badge), please describe the topic and we will create a custom curriculum for your group.

"Down in the Dirt" - soil health, composting, garden ecology, recycling"All About Bugs" - insects, pollinators, biodiversity"Garden Chefs" - nutrition, health, local food systems"Food is Culture" - emphasis on cultural significance of food and indigenous growing traditionsOther
Other notes (please include any additional information or requests for your visit)

Available Group visits time slots are shown in the calendar below.
During the school year, these timeslots are aimed to cater towards afterschool programs. If the listed times don’t work for your group, please include a note about your preferred time for a visit. Depending on our other bookings, we sometimes have flexibility in the times available for visits
Appointment

Garden Visit Liability, Medical, Data Collection, and Photo Waiver

As the guardian of the group, I hereby agree to the following:

I consent to emergency medical care of group participants by Wasatch Community Gardens and its employees, or healthcare providers designated by them, in accordance with their best judgment.
I give permission to Wasatch Community Gardens to use photos, film, and/or quotes of my group for promotional materials, including the Wasatch Community Garden website. I will notify Wasatch Community Gardens of any child that does not have permission to be photographed.
I understand that Wasatch Community Gardens collects data about the participants’ experiences to use for program evaluation purposes. Participants will be asked about their familiarity with activities, whether or not they enjoyed the activities, and if they would like to share reflections about their experiences. The data collected will not be tied to individuals or personally identifiable to a particular participant. All responses are aggregated and none of the information can be traced back to a particular participant.
I hereby release Wasatch Community Gardens, its employees, agents and board of directors from all claims for injury to my group or damage to my group’s property which may result from or occur during participation in the garden visit, and I agree to indemnify and hold harmless Wasatch Community Gardens and its employees, agents and board of directors for any liability for injury to any person and/or damage to property caused by my group’s negligent or intentional act or omission.
General Release and Release Consent for Medical Treatment

As the guardian of the participants, I hereby consent that my group may participate in the Wasatch Community Gardens Group Visit and hereby state that the information contained herein is true and complete.

Release. Recognizing the possibility of physical injury associated with Wasatch Community Gardens Group Visit Program, I hereby release and agree to hold harmless Wasatch Community Gardens, its employees, agents and board of directors for liability for such injury, including but not limited to medical and legal costs, as a result of my group’s participation in the program.
Emergency Medical Care. I hereby give my consent for emergency medical treatment by Wasatch Community Gardens’ employees, or health care provider(s) designated by them, in accordance with their best judgment.
Insurance. I understand that I should have health and accident insurance to cover injuries that may arise from participation in the group visit.
Guardian first and last name:

First NameLast Name
Guardian signature:

Clear
Primary Contact Name:

First NameLast Name
Primary Contact Email:
example@example.com
Primary Contact Phone Number:
Please enter a valid phone number.
Secondary Contact Name:

First NameLast Name
Secondary Contact Email:
example@example.com
Secondary Contact Phone Number
Please enter a valid phone number.
Should be Empty:

Group Visit Request Form

Please complete this form to request a visit to Wasatch Community Gardens. You will be contacted to confirm booking after submitting the form.