Little Brook Farm, Sunderland MA

Register camper(s)

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Camper name *

Age *

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Parent / guardian name *

Email *

Phone 1 *

Phone 2

Phone 3

Address *

Address

City

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Select camp week *

No. of campers *

Payment type *

I am making a camp reservation ($50 per camper)

I am paying full registration fee ($250 per camper)

Payment method *

I will pay online

I will pay by check

Total $

Permission and release

I am fully aware of and understand the inherent dangers in participating in activities involving agriculture and farming.

I acknowledge that the camp is, by its nature, a strenuous activity in an outdoor environment.

I acknowledge that agriculture/farming, as well as other outdoor activities can be difficult and may include strenuous exercises, along with the associated dangers.

I agree that the camp staff and all persons connected with Little Brook Farm have observed all reasonable precautions in providing care and protection of my child/children.

I agree to absolve Little Brook Farm, Kristen Whittle, the camp staff and all others associated with this camp from any liability for any accident or illness which may occur during the duration of this program.

I hereby grant permission to use any camp photos or videos taken of my child/children for publicity or promotional purposes, without compensation now or in the future.

I grant permission for camp staff to make decisions about medical treatment for my child/children in the case of an emergency and in the event I cannot be reached, including permission for camp staff to arrange for transport to the nearest medical facility by ambulance if deemed necessary.

Accept *

I certify that I have read, understand and fully informed myself of the contents of this permission and release form and agree to its terms and conditions. I understand that my email address will be added to the Little Brook Farm mailing list so that I can receive important communications and that I can manage my subscription.

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Permission and release