Sweet Grass Dairy Farm Camp

---May 28 - 31, 2024 (4 days)

---8:30 am - 1 pm

---$150 per camper

---Ages: 3 years old (must be potty trained and have turned 3 by 9/1/23) - 2nd Grade (2023-24 school year)

---Lunch is not provided

Sweet Grass Dairy Farm Camp

19635 US Hwy 19 N

Thomasville, Georgia

31792

Please note: There will not be an email confirmation for a successful farm camp registration. Instead, there will be a statement that comes up after clicking the "submit" icon that says "Thank You the registration was successfully submitted"

Child Information

First Name *

Last Name *

Preferred Name

Gender

Age: As of September 1, 2023, what was your child's age? *

Birth Date: Please be aware of the year you are entering * +

Grade: Please put the grade that your child was in during the 2023-2024 school year. *

T-shirt Size *

Dietary Restrictions/Medical Needs/Allergies *

Adult Primary Contact

Relationship to Child: *

Mother

Father

Guardian

Other Other

First Name *

Last Name *

Address 1 *

City *

State *

Zip *

Phone *

Alternate Phone

Email Address *

Adult Alternate Contact

Relationship to Child: *

Mother

Father

Guardian

Other Other

First Name *

Last Name *

Phone *

Email Address

General Release (please initial)

I hereby consent to the child (the "Child") referred to herein participating in activities organized by Sweet Grass Dairy, LLC ("Sweet Grass") and/or Blue Elephant Farms, LLC ("Blue Elephant") on property (the "Property") owned by Flying Elephant Farms, LLC ("Flying Elephant"), and I agree as follows:

1. I understand that the Child will be participating in recreational activities (the "Activities") organized by Sweet Grass and/or Blue Elephant, and I understand and agree that there are certain predictable and unpredictable risks associated with the Activities, including, but not limited to, risks associated with weather conditions, insects, domesticated animals, wild animals, transport in motorized vehicles, the contraction of viruses, failure of equipment and other such risk. I, individually and on behalf of the Child, hereby willingly and expressly assume the risk of injury or death as a consequence of the Child's participation in the Activities, and I understand that Sweet Grass, Blue Elephant, Flying Elephant, and their respective agents, officers, employees, members, and volunteers (hereinafter collectively referred to as "Releasees") make no representation, express or implied, regarding safety, experience of other participants engaged in the Activities, experience of individuals supervising the Activities, the condition of equipment, the condition of the Property, or any other such matter.

2. I, individually and on behalf of the Child, hereby release, waive, and forever discharge Releasees, and each of them, of and from all liability to me, the Child and our respective heirs, administrators, executors, personal representatives, guardians, legal representatives, spouses, parents, children, or anyone claiming by or through the Child or through me, for any claims, demands, actions, causes of action, damages, or judgments on account of injury or damage to the Child, to me, or to my property (including the loss of such property) that may occur or develop while I or the Child is on the Property, including, but not limited to, injury resulting in death, whether caused by any act or omission, negligent or otherwise, on the part of Releasees, or any of them, or by any act or omission on the part of a third party, or any act or omission on my part or the part of the Child. I further agree not to sue, make a claim against, or prosecute Releasees, or any of them, in any fashion, as a result of any injury or damage to the Child or to me (or the consequences of any such injury or damage) that occurs or develops on the Property, including, but not limited to, any such injury or damage sustained in connection with or arising out of the Activities, or travel to or from a location where the Activities are conducted.

3. Further, I agree to protect, indemnify, hold harmless, and defend Releasees, and each of them, against any claim, action, suit or demand (including Releasees' attorney's fees, costs and expenses, not only in connection with defending against any such claim, action, suit or demand, but also related to the enforcement of any indemnity and hold harmless provision contained in this document) that may be brought or instituted against Releasees, or any of them, by any person or entity (including those asserted for me or on my behalf) because of or in any manner arising from or connected with: (1) the Child's participation in the Activities; (2) the Child traveling to or from a location where the Activities are conducted; and/or (3) any injuries or damages that I or the Child sustain or develop while on the Property. I expressly agree to indemnify and hold harmless Releasees, and each of them, of and from any negligent act or omission on the part of Releasees, or any of them.

4. I understand and agree that the terms of this document shall be legally binding upon me and the Child, as well as our respective estates, heirs, administrators, executors, personal representatives, guardians and other legal representatives.

5. I understand and agree that this document shall be construed in accordance with and governed by the laws of the State of Georgia and is intended to be as broad and inclusive as permitted by the laws of the State of Georgia, and if any portion hereof is held invalid, that the balance shall, notwithstanding, continue in full legal force and effect. *

I hereby consent and agree to the terms and conditions set forth in the General Release.

Name of Child *

Parental Consent (please initial)

I hereby consent to the Child participating in all Activities. *

I give consent.

Treatment Consent (please initial)

In the case of any sudden illness or injury (as solely determined by Releasees, or any one of them) that may occur while the Child is participating in the Activities and/or is present on the Property, I hereby consent to the Child being treated by one or more medical providers, including, but not limited to, emergency medical personnel, doctors, physicians assistants, and/or nurses. It is understood that Releasees will provide no payment or medical insurance for such treatment and that the cost thereof will be at my expense. *

I attest.

Photo Release (please initial)

I hereby authorize Releasees, and any one of them, to film, video record, audio record, and/or photograph the Child, and to publish any such film, recording, or photograph, on any website, social media platform, or printed materials hosted, operated, distributed, or otherwise utilized by Releasees, or any one of them. I further acknowledge and agree that neither I nor the Child has any expectation of confidentiality with respect to the Child’s participation in the Activities. *

I give consent.

I do not give consent.

Attestation (please initial)

I hereby attest that I am a parent of the Child, and/or a person who is duly authorized to act for and on behalf of the Child. *

I attest.

Makeup Policy (please initial)

One or more days of the camp will be canceled if, in the sole discretion of Releasees, or any one of them, weather conditions are such that it is not safe to be outside. If more than one day of camp is cancelled, the cancelled days will be made up at the beginning of the following week, weather permitting. *

I understand.

Covid-19 Agreement (please initial)

I acknowledge that I am hereby advised that there is a sign on the Property that provides as follows: WARNING: Under Georgia law, there is no liability for an injury or death of an individual entering these premises if such injury or death results from the inherent risks of contracting COVID-19. You are assuming this risk by entering these premises. *

I acknowledge.

Payment

Name on Credit Card *

Credit Card Number *

Expiration Date (mmyy) *

CVV *

Billing Zip Code Associated with Credit Card *

Thank you for registering your child for Farm Camp! We will try to accommodate each child's class, but we cannot guarantee that certain children may be placed together. You will be receiving an email closer to date with all information regarding camp! If you have any questions, please email or call us at farmcamp@sweetgrassdairy.com or (229) 227-0752.