Registration Form: Earth Keepers Summer Sessions

ex: 02/22/2014

If we need to reach you during class.

(Allergies, accommodations, etc)

If we can’t reach you.

Please List name and phone number of anyone other than you that may pick up your child.


Waiver and Release Form: Threefold Community Farm

We are pleased your child/ren will be joining classes hosted by Threefold Community Farm, hereto referred to as the FARM. We look forward to seeing you here. While we are ready to provide you with a wonderful and safe experience, there are certain risks that are present when on a working farm. Below is a general waiver that is required prior to classes beginning.

I acknowledge the inherent risk(s) of participating in a class/activity on a farm and working around livestock, which includes (but not limited to):

• the behavior and actions of any animal (including cows, horses sheep and chickens) can be unpredictable and that in working with animals, personal injury or property damage may occur.
• operation of farming equipment and machinery that may result in injury, harm, or death to persons on or around such implements;
• dangers of being in areas marked Do Not Enter, Off Limits to Customers, or any other methods to demonstrate that specific areas are off-limits;
• dangers of not following directions of instructors, farmers or guides;
• exposure to biological or environmental hazards;
• hazards related to climbing ladders, repetitive movements (such as cultivating or picking produce), and exposure to outdoor weather conditions;
• the potential of any participant or spectator to act in a negligent manner that may contribute to injury to the participant or others.

In consideration for enrolling my child(ren) in classes and programs at the Farm, I hereby release from liability and waive my right to sue the Threefold Educational Foundation and School and the Fellowship Community, their employees, officers, volunteers, insurance carriers, and agents (collectively “Threefold Releasees”) from any and all claims, including claims of Threefold’s negligence, resulting in any physical injury, illness or economic loss I may suffer or which may result from my child’s enrollment and participation in programs conducted by the Farm. I understand and agree that this Waiver and Release is binding on my heirs, assigns, and legal representatives.

Indemnification: I also AGREE TO INDEMNIFY AND HOLD HARMLESS the Threefold Releasees from any loss, liability, damage, or costs, including court costs and reasonable attorneys’ fees that Threefold Community Farm may incur due to my participation in said activities, whether caused by the Farm’s ordinary negligence or otherwise, to the fullest extent allowed by law.

I have carefully read this Waiver and Release and fully understand its contents. If my child is under the age of 18, I have completely reviewed this Waiver and Release, understand and consent to its terms, and authorize my child’s participation by my signature below. I am aware that this is a RELEASE OF LIABILITY and a contract between me and the persons and entities mentioned above on behalf of my child and I sign of my own free will.

Financial Policy: Payment is due upon registration. We are not able to refund for missed classes, or prorate for planned absences.

Our classes are rain or shine. That being said, if weather conditions are extreme we will let you know that class will be canceled and do our best to offer a make-up class.



If paying by check, it must be mailed and received before the start of class. Payable and mail to: Threefold Community Farm 260 Hungry Hollow Rd. Chestnut Ridge, NY 10977.