Shipshape Farm 2025 Summer Camp!

Parent/Guardian Name* This field is required.

First Name

Last Name

Address* This field is required.

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Phone Number* This field is required.

Area Code

Phone Number

E-mail* This field is required.

Child #1 Name* This field is required.

First Name

Last Name

#1 Birth Date* This field is required.

#1 Male/Female* This field is required.

Child #1 allergies?* This field is required.

please explain in medical section

Child #1 t-shirt:* This field is required.

youth small

youth medium

youth large

youth x-large

adult small

adult medium

#1 Grade entering

Do you have another camper?

YESNO

Child #2 Name

First Name

Last Name

#2 Birth Date

#2 Male/Female

Child #2 allergies?

please explain in medical section

Child #2 t-shirt:

youth small

youth medium

youth large

youth x-large

adult small

adult medium

#2 Grade entering

Do you have another camper?

YESNO

Child #3 Name

First Name

Last Name

#3 Birth Date

#3 Male/Female

Child #3 allergies?

please explain in medical section

Child #3 t-shirt:

youth small

youth medium

youth large

youth x-large

adult small

adult medium

#3 Grade entering

Do you have another camper?

YESNO

Child #4 Name

First Name

Last Name

#4 Birth Date

#4 Male/Female

Child #4 allergies?

please explain in medical section

Child #4 t-shirt:

youth small

youth medium

youth large

youth x-large

adult small

adult medium

#4 Grade entering

**Cost of camp includes one t-shirt per camper per summer, regardless of number of sessions attending**

**Full day camp - MUST PACK LUNCH**

Shipshape Farm provides a snack in mid-morning and mid-afternoon. The provided snack will be communicated the week prior to your camp session. If you would prefer something different, feel free to send a snack with your camper(s)!

Camp Sessions* This field is required.Please select and review carefully as there is a $25 fee per camper for changes made to camp weeks after registration has been submitted.

Credit Card

First Name

Last Name

Physician Name* This field is required.

First Name

Last Name

Phone Number* This field is required.

Area Code

Phone Number

Medical Concerns* This field is required.If none, please type NONE or N/A

Please mark the name of each child and their concerns/allergies

During farm camp, we will be taking photographs and videos of camp activities to capture and share the experiences at Shipshape Farm. Some photographs or videos may capture your child's participation, directly or indirectly.

These photos and videos may be published through our website, social media pages, or newsletters. ***Photos and videos that do not capture faces will be used. This is an approval for photos and videos that show the face of your child(ren).

We always want to honor desires of each family regarding the online presence of their child(ren).

Please select your preference below:

Photo Release* This field is required.

I authorize Shipshape farm to use photos including the face of my child(ren)

I do NOT authoize Shipshape Farm to use photos including the face of my child(ren)

How did you hear about us?

Please share who we can thank for the referral!(Name of friend who referred you)

Name

First Name

Last Name

Phone Number

Area Code

Phone Number

I hereby give my permission for my child (or children listed above), to participate in a Summer Camp organized by Shipshape Farm LLC. I hereby release, hold harmless and absolve Shipshape Farm LLC staff, farmhands, and all others who have participated in the planning, organizing, and implementing of the activity, be they individuals or organizations, singly or collectively, from responsibility and liability for any illness, injury, misadventure, harm, loss or inconvenience suffered or sustained as a result of the participation in the activity. I understand that in the event my child requires medical treatment while engaged in the activity, reasonable efforts will be made to contact my designated emergency contacts; however, if they cannot be reached, I hereby consent and give my permission to the Shipshape Farm LLC staff to consent to any X-ray examination, medical, dental or surgical diagnosis; treatment; and hospital care advised and supervised by a physician, surgeon or dentist (as appropriate) licensed to practice under the laws of the state where the services are rendered, either as an outpatient or in any hospital. To the best of my knowledge, I have listed above all my child's medical allergies, medications being taken, medical problems and other pertinent information. Finally, I acknowledge that a farm with livestock has inhererent risks. The staff have taken reasonable measures to mitigate against injury, but cannot remove fire ants, animals, bees, or electric fences from the land as a working farm. I hereby release Shipshape Farm LLC from any and all claims, demands, or causes of action in connection with the use and exercise of the rights granted in this release.

Shipshape Farm 2025 Summer Camp!