Flower Camp Registration

Flower Camp Registration

Floral Notes Farm
Information
Camper's Name

First NameLast Name
Nickname (if applicable)
Gender
Birth Date

MonthDayYear
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Session Dates

July 28 - August 1August 4 - 7
Parent/Guardian Information
Name

First NameLast Name
Home Number

Area CodePhone Number
Cell Number

Area CodePhone Number
E-mail
Emergency Information
Emergency Contact #1 Name

First NameLast Name
Relationship
Phone Number

Area CodePhone Number
Alt. Phone Number

Area CodePhone Number
Emergency Contact #2 Name

First NameLast Name
Relationship
Phone Number

Area CodePhone Number
Does the child have any allergies, chronic illness, or medical conditions? If yes, please describe.
Is there anything else that we need to know to provide proper care for your child?
Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by Floral Notes Farm LLC during the selected camp. In exchange for the acceptance of said child’s candidacy by Floral Notes Farm LLC, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Floral Notes Farm LLC and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions.

In case of injury to said child, I hereby waive all claims against Floral Notes Farm LLC including all staff and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the camp. There is a risk of being injured that is inherent in all farm activities. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Signature

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Photography Release

I hereby grant to Sweet Beeginnings LLC, and its assignees and licensees, the right to photograph, audio tape, and/or videotape above child on August 5th through 9th of 2024 or August 12th through 16th of 2024 and the right to use such photographs and moving images, including reproductions or likenesses base thereon, in any manner and in any and all media, all as Sweet Beeginnings or its assignees or licensees all right, including but not limited to the right of copyright, which they may be in or to all such photographs and moving images, and consent to use thereof without limitation by Sweet Beeginnings and its assignees or licensees.

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Signature

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