Registration Form

Please fill in the form below to register. Note that some fields only apply to children's programs. If you are registering for another purpose, please select 'N/A' or include that in the text box if the field is required.

  • Strength Indicator
  • (Required if registering for children's programs, otherwise enter 'NA.')

  • (Required if registering for children's programs, otherwise enter 'NA.')

  • (Required if registering for children's programs, otherwise enter 'NA.')

  • (Required if registering for children's programs, otherwise enter 'NA.')

  • (Required if registering for children's programs, otherwise enter 'NA.')

  • In the event that I cannot be reached in an emergency requiring medical attention for my children, I give my permission for staff to administer first aid/CPR as deemed necessary. Further permission is given to allow medical services to be performed by doctors, hospitals, or other qualified medical practitioners as deemed necessary in an emergency, including surgery if reasonably necessary. I understand that the cost of emergency services is my responsibility.

  • Occasionally, we may take promotional pictures or video, without ever identifying children by name, or telling any personal details.

  • Participation in outdoor programs at Willow Creek Farm exposes participants to certain risks associated with the outdoors. Accidents and injuries resulting from forces of nature, live animal, insect, and plant interactions, slipping and falling, malfunctioning equipment, unseen obstacles, fatigue, and your own and others’ misjudgement are very real possibilities. The Undersigned Certify that they agree as follows: I hereby affirm that I have been informed that there are inherent dangers of participating in an outdoor program. While all program participants are consistently supervised, accidents do happen. The undersigned assumes all risk of injury or harm to the children participating in the program and agrees to release, indemnify, defend and forever discharge Willow Creek Farm and its staff, employees, and agents of and from all liability, claims, demands, damages, costs, expenses, actions and causes of action in respect to death, injury, loss or damage to the children, or by the children, howsoever caused, arising or to arise by reason of or during the child’s participation in the program. I hereby agree to heed at all times the advice and instructions of Willow Creek Farm, and its owners to practice common sense while at this program. The above-named participant minor children, have permission to participate in the activities of Willow Creek Farm. I hereby agree that TYPING MY FULL NAME HERE SERVES AS MY LEGALLY BINDING ELECTRONIC SIGNATURE on this form and my agreement with Willow Creek Farm policies, the liability waiver, and consent statements.

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