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Please fill out our waiver before you start your day!
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Indicates required field
Name
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First
Last
Email
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Kid's name & ages
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Do you consent to have photos/video of your child taken? These may be used on our social media/website.
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Pictures are fine
Pictures without face
No pictures
I understand that no children or adults are allowed on the trampoline
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I agree
Please don't allow your children to go into any pastures, fields, or animal pens without permission from Virgil or Stefani
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I agree
Please list any allergies we should be aware of
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Acknowledgement and Assumption of Risks:
1. I understand and acknowledge that the Cactus Hills Farm programming in which the participant/my child will participate may be physically strenuous and has risks, dangers and hazards including, but not limited to:
A. Hazards associated with being outdoors which may include walking/working on steep, slippery or uneven ground, holds, falling tree limbs or rocks, exposure to managed (grown) vegetables and unmanaged plants (those that grow in nature such as weeds, shrubs, trees, berries etc.), exposure to pollens, dusts.
B. Unpredictable and changing weather that could result in exposure to sunlight, heat, cold, wet or windy weather, lightning, and animals, including dogs,, deer, elk, rodents, snakes, birds, tics, insects, bees, spiders, etc .
C. Hazards associated with using hand tools and hammers, tweezers, scissors .
D. Hazards associated with being around a wood stove.
E. Hazards associated with being in or around a farm.
F. Hazards associated with gardening such as lifting, bending, carrying buckets of produce and using hand tools such as shovels, hoes, trowels, shears and scissors and equipment such as ladders, wheel barrels, buckets, baskets, rope, wire, gloves, etc.
G. Hazards associated with having direct contact with organic materials such as composted materials, food, scraps, earth, manures, worms, etc.
H. Hazards associated with becoming separated from guides or companions and in inability to communicate or access rescue and medical help. I. Theft, vandalism or loss of personal property.
J. Hazards associated with farm animals, cows, horses, donkeys, alpacas, sheep, chickens, turkeys, ducks, geese, cats and dogs.
2. I acknowledge that participating in the Cactus Hills Farm program involves inherent risks and other risk hazards and dangers, including some not listed above that can cause or lead to death, injury, illness, property damage or loss, mental or emotional trauma, or disability.
3. I have been informed of my right to obtain as much information about this program activity from Cactus Hills Farm as I feel necessary, including information beyond that information provided to me herein respecting the nature and the extent of risks and hazards associated with the program or activity and I acknowledge that I am satisfied with the information provided to me.
4. I agree Cactus Hills Farm shall not be responsible for any adverse health or medical conditions of my child.
5. In entering into this Agreement I am not relying upon any oral or written representations or statements made by the Released Parties other than what is set forth in this Agreement.
6. I freely and voluntarily agree to assume all of the risks of the activities of my child’s Farm Camp program whether inherent or not and whether described above or not and understand any acknowledgement that my child, as a participant may suffer personal and potentially serious injury due to an unforeseeable or fortuitous event.
I have read the above and agree with the terms. *
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I agree
7. Liability Release and Indemnity Agreement. I hereby release, indemnity and hold harmless Cactus Hills Farm and each of its respective employees, officers, independent contractors, subcontractors, volunteers and all other persons or entities acting for or under the discretion and control of Cactus Hills Farm and agree to waive any and all claims that my child or I have or my spouse or other parent or successors or assigns have or may have in the future against the Released Parties for, any loss, damage, injury, claim or expense in any way associated with my child’s participation in the Cactus Hills Farm program or the use of any equipment or facilities. Neither I nor anyone acting on my or my child’s behalf will make a claim against the Released Parties as a result of injury, illness, damage, death or loss to person or property, whether arising from negligence, breach of contract or breach of any statutory or other duties of care, including any duty of care owed under the Occupiers Liability Act or similar law for the exemption of liability on public and/or recreational lands. I further agree to hold harmless and indemnify the Released Parties from any and all liability for any damage to the property or, or personal injury to any third party, including other participants in the program resulting from any child’s participation in the program. I have read this Release of Liability and Assumption of risk, fully understand its terms, understand that I have given up substantial rights by signing it and sit it freely and voluntarily without any inducement. I agree that this form shall be binding on me, my minor and/or adult children participants, my spouse or partner and other family members, my heirs, executors, representatives, successors and assigns. I hereby confirm that I have legal authority to act on my child’s behalf. I agree on my own and on my child’s behalf to the terms and conditions in this document.
By selecting I agree below, you have read and agree with the terms outlined above.
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I agree
Your signature - By signing your name below you agree to all stated above.
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Submit
Home
About
>
Contact
Blog
Meet our Animals
Highland Cows
Jerseys
Babydoll Sheep
Swiss Valais Blacknose
Mini Donkeys
Goldendoodles & Mini Bernedoodles
Hatchery
Kid's Farm Camp
Equipment Rentals
Shop