Wild Designers — Registration & Waiver

Welcome to Wild Designers

A biomimicry-inspired workshop for curious kids, ages 7–10
Nature has been innovating and solving hard problems for 3.8 billion years. What if your child could learn to think the same way?

Biomimicry is the practice of learning from and applying nature's designs to solve human challenges — it's how Velcro was invented by studying burrs, how bullet trains were redesigned after the kingfisher's beak, and how your child will start to see every plant, creature, and system as a potential teacher.

This is a small group - six kids max - which means your child gets to go deep, not just wide. Each session has a big question, a hands-on build or sketch, and time to just be outside and pay attention. No right answers. Lots of good mess.

Your facilitator is Leemor Chandally - experience designer, parent, and currently homeschooling my own kid for a year. My background spans biomimicry, urban planning, and regenerative design - disciplines I bring together to reconnect people with life's inherent genius, the intelligence already present in nature and in us. Wild Designers is the program I wanted for my own child - and for myself!

Program Details

Dates: May 19–June 2
Days: Tuesdays (5/19, 5/26, 6/2)
Time: 4:30–6:00 PM
Location: Woodend Nature Sanctuary
Cost: $90

This form takes about 5 minutes to complete and collects your child’s basic information, health and safety details, pickup authorization, and program waiver. Please read the waiver carefully before signing.

Questions before registering? Reach us at leemor81@gmail.com.

Child's full name
Date of birth

MonthDayYear
Date
Preferred name or nickname
What would your child like to be called?
Current grade and school name
Parent or guardian full name
Relationship to child
Email address
We'll send your confirmation and welcome packet here
Mobile phone number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency contact full name
Emergency contact phone number
Please enter a valid phone number.Format: (000) 000-0000.
Second emergency contact full name
Second emergency contact phone number
Please enter a valid phone number.Format: (000) 000-0000.
Does your child have any allergies? Please list all food and environmental allergies. If none, please write None.
Are there any medical conditions, diagnoses, or physical limitations we should be aware of? If none, please write None.
Is your child currently taking any medications? If yes, please list the medication, dosage, and timing. If none, please write None.
Does your child carry an EpiPen or inhaler? If yes, please ensure they have it with them at every session.
Is there anything else you'd like us to know about your child? This might include sensory sensitivities, social preferences, learning differences, or anything that would help us support them well.
Authorized pickup person full name
Authorized pickup person relationship
Your child will only be released to adults listed here, in addition to the registering parent or guardian. Please bring photo ID.
Second authorized pickup person full name
Second authorized pickup person relationship
Will your child be walking home independently or self-releasing at the end of sessions?
If yes to self-release, describe the arrangement
WILD DESIGNERS — PARTICIPANT ENROLLMENT, WAIVER & RELEASE OF LIABILITY

Please read this document carefully and completely before signing.

1. PROGRAM DESCRIPTION
Wild Designers is a nature-based afterschool enrichment program for children ages 7–10. Sessions take place primarily outdoors and include: observing and interacting with plants, insects, soil, and natural materials; building with natural and reclaimed materials; exploring biomimicry through hands-on design challenges; nature journaling and sketching; and sensory engagement with outdoor environments including uneven terrain, water, and weather.

2. ACKNOWLEDGMENT OF INHERENT RISKS
I understand that participation in outdoor, nature-based activities involves inherent risks including but not limited to: uneven or slippery terrain; exposure to insects including stinging and biting insects; contact with plants that may cause allergic reactions; sun exposure and weather-related conditions; use of natural and craft materials including scissors, string, clay, and wood; minor cuts, scrapes, bruises, or sprains; interaction with soil, mud, and water. I acknowledge that there may be unknown risks that cannot be foreseen and that participation is voluntary and taken at our own risk.

3. RELEASE & WAIVER OF LIABILITY
In consideration of my child's participation in Wild Designers, I hereby freely and voluntarily release, waive, and discharge Wild Designers, its facilitators, instructors, volunteers, partner organizations, and host venues from any and all claims, demands, losses, damages, or liability arising from my child's participation, whether caused by negligence or otherwise, to the fullest extent permitted by law.

4. INDEMNIFICATION
I agree to indemnify, defend, and hold harmless the Program and its facilitators from any and all claims, losses, damages, or expenses arising from my child's participation or from my own actions or omissions in connection with this Program.

5. EMERGENCY MEDICAL AUTHORIZATION
I authorize Wild Designers facilitators to: administer basic first aid; contact emergency medical services (911) if deemed necessary; and seek emergency medical treatment on my child's behalf if I cannot be reached. I agree to hold the Program harmless for any injury or consequence resulting from emergency care provided in good faith.

6. HEALTH & WELLNESS AGREEMENT
I agree to keep my child home if they are sick or show symptoms of communicable illness; notify the program if my child tests positive for a contagious illness within 48 hours of attending; ensure my child arrives dressed appropriately for outdoor activity; and pack any required medications in my child's bag at every session.
Parent or guardian signature
Date signed

MonthDayYear
Date
Photo & video release — please select one:
Payment

To confirm your spot, please send $90 within 48 hours of submitting this form.

Venmo @Leemor-Chandally OR Zelle leemor81@gmail.com

Please include your child's name in the payment note (e.g., Wild Designers — [child's name]). You'll receive a welcome email once payment is confirmed.
How did you hear about Wild Designers?
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Welcome to Wild Designers