Harmony Farm Visitation Form

1

Name* This field is required.

First Name

Last Name

2

Email* This field is required.

example@example.com

3

Phone Number* This field is required.

Area Code

Phone Number

4

Date* This field is required.

Date

5

What time of day would you like to visit?* This field is required.

Morning

Afternoon

Evening

Night

6

Alternate Date

Date

7

Type a question

Morning

Afternoon

Evening

Night

8

Type a question* This field is required.Have you been to Harmony Farm Before?

YESNO

9

I have read, and agree to this liability release and self responsibility pledge* This field is required.1. By your presence on this property you agree and hereby release from liability, and to indemnify and hold harmless, the property owners for any and all personal injuries and property losses or damages to your person or property occasioned by, or in connection with your visit here. 2. The owner reserves the right to withdraw such permission to be present on this land to any person, at any time, for any reason. 3. All visitors are to obey any rules or guidelines, posted, online or physically, or voiced by the owners. This includes confining one’s visit to the labyrinth and adjacent areas, and to honor the privacy of the owner's home, an off-limits area of the property except during Harmony Farm events. 4. Children are welcome and are the full responsibility of parents or guardians who bring them. This is not a playground, and visitors are encouraged to help their children to understand how to respect sacred space and objects. 5. Visitors shall be responsible for any damage to property that they might inflict. 6. A separate waiver of liability must be signed for extended stays on the land.

Yes

10

Additional notesPlease type any notes you would like me to see.

11

Donations are always welcome* This field is required.

Description

USD

+ OR enter a custom value

Donations are always welcome

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