Farm Club Enrollment Form

FARM CLUB

Farm Club is a drop off program on Wednesdays from 5-630pm. Enrollment is rolling based on a 4 week unit. We do not offer a la carte (single week) enrollment. More information about our units, content and dates can be found on our website. Once this form is received, you will receive an email confirmation and an invoice within 1-2 business days to the email provided under "Parent/Guardian 1"
Farm Club Registration Form

These forms are required for your children to attend club.
Student's Information
Member ID
Student Name
Preferred Nickname
Date of Birth

MonthDayYear
Age
Gender
NOTE - Kids Farm Club is for children ages 5-11 (Kindergarten-6th graders) Children need to be fully potty trained before they are eligible to participate in club.

Due to limited seating, we are a drop off program and cannot accomodate parents in the learning space. You are able to wait in the creamery or enjoy our outdoor grounds if you choose not to leave.
Grade in 2026/27
School Student Attends
Please provide any additional information that you think is important or may affect the camper's ability to fully participate in the camp program.

Guardian Information

Primary Contact Point (this person will be contact with all club information)
Parent/Guardian 1

First NameLast Name
Relationship to Child
E-mail
Cell Phone
Format: (000) 000-0000.
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How would you like to be reached in case of emergency while your child is at club?
Contact # 2

Who would you like us to reach if you are not available?
Parent/Guardian 2

First NameLast Name
Relationship to Child
E-mail
Cell Phone
Format: (000) 000-0000.
Home Address Same as Parent/Guardian 1?
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How would you like to be reached while your child is at club?

Emergency Contacts/Authorized Pickup

List the name of at least one person who can be contacted in the event of an emergency or illness if you cannot be reached. Any person listed should be able to assist in contacting you. At least one person listed must be within 1 hour of the club location, able to take responsibility for the child in case the parent/guardian cannot be contacted. Both emergency contacts should be able to produce valid photo ID and be authorized to pick up your child from club.
Emergency Contact/Authorized Pick Up

Emergency Contact #1
Full Name

First NameLast Name
Primary Phone Number
Format: (000) 000-0000.
Relationship to Child
Emergency Contact/Authorized Pick Up

Any additional adults authorized to pick up your child.
Full Name

First NameLast Name
Primary Phone Number
Format: (000) 000-0000.
Relationship to Child

FARM CLUB