Please ensure you have read the student handbook and acknowledge  cancelation policy, and other important information. By signing this form you are acknowledging that you understand and agree with these terms.

Camp Cancelation:

Deposits are non-refundable. If greater than 30 days prior to camp start, remaining balance can be refunded. If less than 30 days before camp start date, no refunds are available.

Student Handbook

All Personal Information provided to the ROOTS YDP will be treated in accordance with the terms of the school Privacy Policy. By affixing your signature above, you agree that you have read the Student Handbook and that you have agreed to all the polices and procedures as described in the Student Handbook.

Enrollment Form Notice

Our new software system with a Parent Portal is almost ready to launch! Because we want to make sure it’s working smoothly and free of bugs before releasing it, we are returning to Jotform enrollment for now to collect all necessary information before camp.

Please fill out this form completely, including your child’s medical profile, allergies, authorized pick-up contacts, and any other required details. If your child will need medications administered during the day, please also email the camp director at info@roots302.com with the necessary information.

We will do our best to transfer the information you provide here into your Parent Portal once it’s live, so you won’t have to re-enter everything later. Thank you for your patience as we finalize this exciting upgrade!

By submitting this form, you are also agreeing to the Student Handbook and Cancellation Policies found HERE.

I, {parent}, the parent of a child(ren) at ROOTS Youth Development Program (Hereinafter known as the "ROOTS"), agree to the following: I understand that my child(ren) whose name is listed below may be photographed at ROOTS during normal program activities. I understand that these photographs may be used in promoting ROOTS services, either in print or on the Internet. 

With my signature below I grant permission for my child(ren) to be photographed, or their images recorded for print or electronic use in promoting ROOTS. I understand that it is my responsibility to update this form in the event that I no longer wish to authorize the above uses. I agree that this form will remain in effect during the term of my child's enrollment. I understand that there will be no payment for me or my child's participation in this release.

**Should you wish to opt out of photos-- please email the camp director at info@roots302.com directly to add this as a note on their roster! 

1.) GENERAL

In consideration for my and/ or my child(ren)'s participation in R.O.O.T.S. Youth Development Program (AKA ROOTS Farm & Forest School at 22424 Peterkins rd Georgetown DE 19947, Lavender Fields at Warrington Manor Milton DE, and 556 Oak Hill School Rd Townsend, DE hereinafter referenced as "ROOTS,' I understand by participating in ROOTS that I hereby RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE the Program, R.O.O.T.S. YOUTH DEVELOPMENT PROGRAM LLC, and their respective employees, agents, representatives and volunteers (hereinafter referred to as "RELEASEES") from any and all liability, claims, demands, actions and causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, that may be sustained by me or my student, or to any property belonging to me, WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES or otherwise, while participating in the ROOTS, or while in, on or upon or away from the premises where the program is being conducted. This will also include all online communications, services, field trip outings, indoor and outdoor learning that are rendered away from ROOTS at 22424 Peterkins rd Georgetown DE 19947.

2.) ACKNOWLEDGMENT OF RISK

I am fully aware of the risks and potential hazards connected with participating in ROOTS, including but not limited to, the risk of loss of personal property from theft, injuries during outdoor learning, farming on premises of ROOTS, or field trips off premises; injuries associated with ROOTS that may or may not be foreseeable, and I hereby elect to voluntarily participate in ROOTS, and engage in such activity knowing that the activity may be hazardous to my child and my property. ROOTS participants may be immersed in the community on and off premises.

3.) ACKNOWLEDGEMENT OF GOOD PHYSICAL CONDITION

I further acknowledge my child(ren) is/are in good physical condition and I do not know of any medical or physical condition or other reason that I or my child(ren) should not participate in ROOTS or which could interfere with my child(ren)'s safety in such ROOTS, or else I am willing to assume-and bear the cost of-all risks that may be created, directly or indirectly, by any such condition. My or my child(ren)'s, any of our family members', or friends' participation in any ROOTS activity is purely voluntary, and I elect to have me and/ or my child(ren) participate in spite of the risks and known or unknown dangers associated with ROOTS activities.

4.) RELEASE AND WAIVER OF LIABILITY

I HEREBY EXPRESSLY RECOGNIZE AND ASSUME ALL RISKS ASSOCIATED WITH MY OR MY CHILD(REN)'S PARTICIPATION IN ROOTS AND VOLUNTARILY RELEASE, WAIVE, DISCHARGE, COVENANT NOT TO SUE AND HOLD HARMLESS THE RELEASEES. I AGREE TO INDEMNIFY AND HOLD HARMLESS the RELEASEES from any loss, liability, damage or costs, including court costs and attorneys' fees, that may incur due to my or my child's participation in ROOTS, WHETHER CAUSED BY THE NEGLIGENCE OF RELEASEES or otherwise. It is my express intent that this Participant Release, Consent and Waiver of Liability shall bind the members of my family and spouse, ifI am alive, and my heirs, assigns and personal representative, if I am deceased, and shall be deemed as a RELEASE, WAIVER, DISCHARGE AND COVENANT NOT TO SUE the above-named RELEASEES. I hereby further agree that this Participant Release, Consent and Waiver of Liability shall be construed in accordance with the laws of the State of Delaware.

5.) In the event that any provision contained within this Release of Liability shall be deemed to be severable or invalid, or if any term, condition, phrase or portion of this agreement shall be determined to be unlawful or otherwise unenforceable, the remainder of this agreement shall remain in full force and effect, so long as the clause severed does not affect the intent of the parties. If a court should find that any provision of this agreement to be invalid or unenforceable, by that by limiting said provision it would become valid and enforceable, then said provision shall be deemed to be written, construed and enforced as so limited. IN SIGNING THIS AGREEMENT, I ACKNOWLEDGE AND REPRESENT THAT I have read the foregoing Consent and Waiver of Liability, understand it and sign it voluntarily as my own free act and deed; no oral representations, statements, or inducements, apart from the foregoing written agreement, have been made; I am at least eighteen (18) years of age and fully competent; and I execute this Agreement for full, adequate and complete consideration fully intending to be bound by same. 

**If your child(ren) is/are not potty trained: Please ensure you take your child(ren) to use the restroom before class starts, at time of arrival; and ensure your child(ren) has/have a dry diaper before start of the camp**

I understand any prescription and OTC medications taken by my child and/or to be dispensed to my child MUST be in the original container from the pharmacy with the original label and directions attached, or I must have a copy of the prescription from the doctor, in order to be dispensed by the camp nurse or qualified staff. If your child takes any over the counter medicine regularly or on an as-needed basis, for example, Sudafed or Benadryl, please send the medicine with written instructions, the original box/bottle with dosing instructions (how it came purchased), and parent signature. Failure to follow these rules will result in the parent or guardian being required to deliver these before any medications can be given.

Sick Student Policy -

Please do not bring your child unless they have been at least 72 hours fever free and no signs or symptoms of illness such as, but not limited to, diarrhea, stomach pain, vomitting, coughing, runny nose, headache, sore throat, etc

COVID-19 Exposure Policy -

If you or your child are exposed to COVID-19, Please ensure to follow dept of health regulations for this and inform your teacher of exposure.

By signing below, I, the parent / guardian, of the student(s) being enrolled acknowledge the Medical Profile has been completed to the best of our knowledge. We agree and understand the Sick and COVID Exposure Policy and will adhere to the policies laid out above.

I understand any prescription and OTC medications taken by my child and/or to be dispensed to my child MUST be in the original container from the pharmacy with the original label and directions attached, or I must have a copy of the prescription from the doctor, in order to be dispensed by the camp nurse or qualified staff. If your child takes any over the counter medicine regularly or on an as-needed basis, for example, Sudafed or Benadryl, please send the medicine with written instructions, the original box/bottle with dosing instructions (how it came purchased), and parent signature. Failure to follow these rules will result in the parent or guardian being required to deliver these before any medications can be given.

Sick Student Policy -

Please do not bring your child unless they have been at least 72 hours fever free and no signs or symptoms of illness such as, but not limited to, diarrhea, stomach pain, vomitting, coughing, runny nose, headache, sore throat, etc

COVID-19 Exposure Policy -

If you or your child are exposed to COVID-19, please do not come to the workshop. Please ensure at least a 14 day window from exposure, to returning to our workshops. Please email the ROOTS Program Director at RootsYouthDevelopmentProgram@gmail.com to notify them of any known COVID-19 potential exposure that could directly affect workshop members.

By signing below, I, the parent / guardian, of the student(s) being enrolled acknowledge the Medical Profile has been completed to the best of our knowledge. We agree and understand the Sick and COVID Exposure Policy and will adhere to the policies laid out above.

I understand any prescription and OTC medications taken by my child and/or to be dispensed to my child MUST be in the original container from the pharmacy with the original label and directions attached, or I must have a copy of the prescription from the doctor, in order to be dispensed by the camp nurse or qualified staff. If your child takes any over the counter medicine regularly or on an as-needed basis, for example, Sudafed or Benadryl, please send the medicine with written instructions, the original box/bottle with dosing instructions (how it came purchased), and parent signature. Failure to follow these rules will result in the parent or guardian being required to deliver these before any medications can be given.

Sick Student Policy -

Please do not bring your child unless they have been at least 72 hours fever free and no signs or symptoms of illness such as, but not limited to, diarrhea, stomach pain, vomitting, coughing, runny nose, headache, sore throat, etc

COVID-19 Exposure Policy -

If you or your child are exposed to COVID-19, please do not come to the workshop. Please ensure at least a 14 day window from exposure, to returning to our workshops. Please email the ROOTS Program Director at RootsYouthDevelopmentProgram@gmail.com to notify them of any known COVID-19 potential exposure that could directly affect workshop members.

By signing below, I, the parent / guardian, of the student(s) being enrolled acknowledge the Medical Profile has been completed to the best of our knowledge. We agree and understand the Sick and COVID Exposure Policy and will adhere to the policies laid out above.

I understand any prescription and OTC medications taken by my child and/or to be dispensed to my child MUST be in the original container from the pharmacy with the original label and directions attached, or I must have a copy of the prescription from the doctor, in order to be dispensed by the camp nurse or qualified staff. If your child takes any over the counter medicine regularly or on an as-needed basis, for example, Sudafed or Benadryl, please send the medicine with written instructions, the original box/bottle with dosing instructions (how it came purchased), and parent signature. Failure to follow these rules will result in the parent or guardian being required to deliver these before any medications can be given.

Sick Student Policy -

Please do not bring your child unless they have been at least 72 hours fever free and no signs or symptoms of illness such as, but not limited to, diarrhea, stomach pain, vomitting, coughing, runny nose, headache, sore throat, etc

COVID-19 Exposure Policy -

If you or your child are exposed to COVID-19, please do not come to the workshop. Please ensure at least a 14 day window from exposure, to returning to our workshops. Please email the ROOTS Program Director at RootsYouthDevelopmentProgram@gmail.com to notify them of any known COVID-19 potential exposure that could directly affect workshop members.

By signing below, I, the parent / guardian, of the student(s) being enrolled acknowledge the Medical Profile has been completed to the best of our knowledge. We agree and understand the Sick and COVID Exposure Policy and will adhere to the policies laid out above.

I acknowledge that if my child(ren) is sick, ROOTS Farm & Forest School qualified staff will attempt to make my child comfortable and call myself (the parent/guardian) first, followed by emergency contact/authorized pick up, to pick up my child from camp, accordingly. By signing below, I am agreeing to pick up my sick child or make arrangements for a pre-designated/authorized pick up person to pick up my sick child from camp. I agree not to send my child to class if he/she has had a fever, cough, sore throat, upset stomach, diarrhea, etc within the last 48hrs.

I understand that my child(ren) may require medication for minor medical conditions. Such conditions may include (but not limited to) headaches, sunburn, poison ivy, bug bites, upset stomach, scrapes, cuts, and/or bee bites. I understand there will be a licensed nurse or qualified staff with First Aid CPR Training, to handle minor health problems and medication administration, but the camp nurse or qualified staff will not be able to medicate my child without permission from the parent or guardian. The following over-the-counter medications may be administered to my child, as needed, following the suggested dosage guidelines (INITIAL ALL THAT YOU GIVE PERMISSION FOR THE CAMP NURSE OR QUALIFIED STAFF TO ADMINISTER.) Medication and/or conditions not covered by your advanced permission will require a phone call to you before any medication can be given, and may cause delay in treatment.

1. It is our policy to notify a parent/guardian when a child needs emergency medical attention. If we cannot contact a parent/guardian, we will need to get immediate help for the child. Our procedure is to call for an ambulance.
2. This consent will go with the child in the ambulance to the proper nearest emergency center.
3. R.O.O.T.S Youth Development LLC  is not responsible for any fees incurred due to needing to utilize Ambulance services.
4. I hereby give consent for my child {Child's Name} to be taken to the nearest emergency center/hospital if needed in an emergency medical situation at ROOTS programs.
5. I hereby give consent for my child named above to receive medical treatment.

I am signing to state these medications, along with standard First Aid practices, can be administered should my child need it. We will also notify parents of administration. 

Tylenol/Acetaminophen for headaches, muscle aches and pains, cramps
Advil/Ibuprofen for headaches, muscle aches and pains, cramps
Pepto-Bismol for nausea, diarrhea, stomach ache
Calamine lotion for stings, insect bites, poison ivy
Benadryl Lotion (topical) for insect bites, stings, poison ivy, burns
Hydrocortisone cream for poison ivy or other rashes
Baking soda paste for stings, bug bites
Triple Antibiotic Ointment w/band aid for scrapes and cuts
Hydrogen Peroxide for scrapes and cuts
Rubbing alcohol for scrapes and cuts
Solarcaine for sunburn
Aloe plant for sunburn or other burns
Non-Drowsy Benadryl (oral) for sinus, allergies, rashes
Halls Kids Sore Throat cough drops
Apply sunscreen & bug spray as needed

**Should you disagree with the above-- please email the camp director at info@roots302.com to make a note on your roster of this information.