Farmer's Procrastin' Acres LLC Farm Club Registration Form
Please fill out your details and provide your e-signature to complete your registration.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
I have read and agree to the liability waiver above.
*
I agree
Child Name
Child Age
Any allergies?
Yes
No
Allergy details
5. PHOTO RELEASE (OPTIONAL) I [ ] DO [ ] DO NOT give permission for Farmer's Procrastin' Acres LLC to use photos of the participant for promotional purposes (Facebook, flyers, website).
Photo Release
DO
DO NOT
E-Signature
*
Register
Register
Should be Empty: