2025 Farm Camp Registration

2025 Farm Camp Registration
Please Note: Submit 1 form per child.

Week 4 is for children entering 5th - 8th grade for the 2025-2026 school year.

Drop off begins at 8:45am and pickup is at 3:00pm. Before care begins at 8:00am and after care ends at 4:00pm.

Before care is available for $25/week.

Aftercare is also available for $25/week.

Before and After care MUST be paid for during registration.

Please contact Abby Collins, Director of Education, with any camp questions at abbyc@thelandsathillsidefarms.org
Fill In Your Child's Information Below
Email address*
Session(s)- One Session per child*

July 14th - July 18th
CHILD'S name (first and last)*
Child's Age*
Child's Grade (entering for 2024-2025 school year)*
Child's T Shirt Size*
PARENT/GUARDIAN Name*
Parent/Guardian Full Address*
Parent/Guardian Phone Number*
Parent/Guardian Email*
Emergency Contact Name and Phone Number*
Allergies*

NoneHay FeverPoison IvyInsect StingsOther DrugsFoodOther
Specify food, insect, drug, or other allergy (if applicable)
Health Conditions*

NoneBleeding DisorderConvulsions/EpilepsyLearning DisabilityBehavioral IssuesDiabetesAsthmaADD/ADHDOther
Specify condition and directions for staff (if applicable)
Names and phone numbers of others authorized to pick up your child*
Photo Release: I hereby give my permission for my child's photograph to be used in The Lands at Hillside Farms publications and for advertising and promotions. *

YesNo
Authorization for On-Farm Transportation: I hereby give my permission for my child to be transported by TLHF staff to on-farm destinations a part of the camp experience. *

YesNo
TLHF acknowledges that your child has voluntarily enrolled in Summer Farm Camp on TLHF's property at 65 Hillside Road, Shavertown, PA (the "property"). TLHF is a working farm. As such, heavy duty farming equipment, live animals, electrified fences, and other such hazards inherent to farming activities exist on the Property and may pose a danger to your child. You, by checking the box below for this Release and Waiver of Liability, on behalf of yourself and your child hereby release and hold harmless TLHF and its officers, directors, employees from any and all liability resulting from any injury your child may sustain in connection with and arising out of such hazards or in connection with your child's participation in the Summer Farm Camp, or your child's presence on the Property.*

I understand.
Sign and Date*
I understand that my child is required to bring a hearty lunch, water bottle, and a change of clothes and shoes to camp daily. TLHF will provide snacks unless otherwise specified due to allergies.*

Yes
Drop Off begins at 8:45 am. Pick up is at 3:00 pm. Before Care and After Care must be paid for with camp registration.*

I do not require before care or after care.I require before care. Before care begins at 8:00.I require after care. After care ends at 4:00.I require BOTH before and after care.
SPECIAL INSTRUCTIONS: Please provide us with any special instructions or requests for your child.
I have reviewed the Code of Conduct and Refund Policy*

Yes
Code of Conduct:

https://docs.google.com/document/d/1MpjgIx0TLCI-NKNtJhR5wnbmDJzqLvnO5lQU9sGjPBM/edit?usp=sharing

Refund Policy:

https://docs.google.com/document/d/1V9CMRA89FJ9WmdlLu-Oz-jFbbYazuryRw6VgjQUvhpk/edit?usp=sharing
PLEASE COMPLETE ONE REGISTRATION FORM PER CHILD. WE CANNOT ACCEPT MULTIPLE CAMPERS ON ONE FORM.
Should be Empty:

2025 Farm Camp Registration

Fill In Your Child's Information Below