Instructions *

Please complete the form below with your student's information. Once completed, you must choose a summer camp option to be enrolled in the program. This form does not guarantee enrollment for your student.

I understand that after completing this information form, I must select and purchase a summer camp option for my student to hold a place in the Summer on the Farm Program.

Student's Name *

First Name

Last Name

Student's Date of Birth *

MM

DD

YYYY

Parent/Guardian #1 *

First Name

Last Name

Best Contact Phone Number *

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Additional Contact Phone Number

(###)

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Parent/Guardian #2

First Name

Last Name

Best Contact Phone Number

(###)

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Additional Contact Phone Number

(###)

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Medication Policy *

I understand that a signed parent/guardian permission and a physician's note are required prior to the administration of any medication (prescribed or over-the-counter) to my child.

I agree.

At Redbud Farm School, we believe camp should be fun for everyone! Students who exhibit disruptive, unsafe, harmful, or inappropriate behaviors will be removed from camp and no refund will be issued. *

I agree.

I agree that my child is 100% potty trained. Please see the Toileting Policy below. *

Redbud Farm Toileting Policy: All students must be 100% potty trained to attend Redbud Farm School. Diaper changing facilities are not available. If your child has more than 2 accidents in a month’s period, or has accidents on a consistent basis, we will ask that your child take a two-week break to work on potty training. The student’s spot will be held, and tuition will still be due for the two-week period. If the child continues to have accidents, his or her enrollment will be terminated for the remainder of the school year. The student will be eligible for re-enrollment but may be required to repeat the current grade. Students will be expected to attend to their own personal needs. For liability and supervision purposes, teachers will not be allowed to change or wipe students. If your student has an accident and is not able to change themselves, a parent or guardian will be called to pick up the student.

I agree. My child is 100% potty trained.

Farm Waiver. Do you agree to the following? *

I/We hereby acknowledge the following risks that our child(ren) may be exposed to at school/camp including but not limited to: Ø Animals (unpredictable or unexpected movement or behavior, germs, bacteria, manure, etc.) Ø Crafts & Kitchen Hazards (cutting, gluing, cooking) Ø Outdoor Risks (sun, heat, insects) Ø Equipment such as Tractors & Farm Equipment Ø Sporting & Play Activities (running, jumping, climbing, falling, tripping, throwing, climbing trees) It is my/our desire for our children to participate in the program and activities offered at Redbud Farm School and acknowledge this waiver will limit my future legal rights. I/We agree to discuss personal safety and procedures related to the above noted risks with my child(ren) prior to the start dates of the camp, school session, or individual activity including: managing personal health issues, allergies and medication, awareness and respect for animals, hygiene and hand washing procedures before eating and after touching animals, farm safety and avoidance of moving equipment, sun screen, hats, hydration, and respect for staff, following farm rules and making friends with other. I/We hereby agree to release, hold harmless and indemnify Redbud Farm School, Southwood Children’s Academy, LLC, President Erin Dulle, and all farm and school employees from all liability, loss, damage, death, or injury claims however caused arising from my child’s participation. I/We assume all risk of participation voluntarily and acknowledge I/we may withdraw or limit our child’s/children’s participation at any time from any activity. I/we agree that I will find alternate care for my child during these activities. I/we understand that withdrawal will not change my financial obligations as agreed up at enrollment. I/we assume responsibility to inquire, ask or discuss in advance the nature of any activity we wish to avoid and communicate that in advance.

I understand and agree.

Clothing: I agree to send my child in weather-appropriate clothing. NO accessories, flip flops, sandals or shoes with holes. *

I agree.

Photo Permission *

The Parent agrees to allow the Student’s photograph, voice, image, and information to be used by the School for use in the School’s publications, promotional materials, social networks, and websites, without compensation and without prior notice. Parent also allows Student to be interviewed by the media on campus or at school-related events. Parent releases and holds the School harmless from any liability stemming from the use of the Student’s photograph, voice, image, or information.

I agree.

I disagree.

I understand that photographs will be taken of all students for internal purposes including distribution and communication with with parents, for classroom projects or for identification. *

I agree.

Sunscreen and Insect Repellent *

I understand that parents/guardians are responsible for applying sunscreen and insect repellent to their children in the morning, and campers are responsible for bringing and applying their own sunscreen and insect repellent while at camp. Staff are unable to apply sunscreen or insect repellent.

I agree.

I understand that cancellations will not be accepted after May 1, 2025. After this time the parent will be responsible for the full amount of tuition agree to when registering. If you choose to withdraw your child after the May 1st deadline, the entire balance of the tuition will immediately be payable to the school. *

I agree.

Which method of payment do you prefer?

Redbud Farm School will accept cash or credit/debit card. Personal checks are not accepted.

Cash paid at the school.

Credit or Debit Card (will incur a fee up to 3.5% on all charges)