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Foraging, Off Site Camping, Retreats and Volunteer Release of Liability Form
-You must fill this and emergency contact form before any activity with me. Thank you.

First name

Last name

Email

Date of Birth

Do you have any health issues?

No

Yes

Please specify anything we should know about

Initials

I declare that the info I’ve provided is accurate & complete

I hereby acknowledge this is a release from all liability for accidental injury or illness which I may incur as a result of participating in any physical activity on the farm and at any location there is a class or foray. I hereby assume all risks connected therewith and consent to participate in this program. I agree to disclose my physical limitations, disabilities, ailments, or impairments which may affect my ability to participate in this program, class or foray.

Thanks for submitting!

Emergency Contact Form

YOUR OWN DETAILS:

First name

Last name

Email

Phone

Address

YOUR EMERGENCY CONTACT DETAILS:

Contact First Name

Contact Last Name

This contact is my

Contact Phone Number

Contact Email

Thanks for submitting!
We’ll contact this person only in case of emergency.