SPRING BREAK CAMP 2020

Nature lovers and local foodies will love our
hands on garden play and farm fresh activities.

ABOUT THE SPRING BREAK CAMP AT FAIRVIEW GARDENS

Spring Break Camp is here! Nature lovers and local foodies will love our hands on garden play and farm fresh activities. Campers will indulge in the beauty and magic of Fairview Gardens everyday for a week with our fun and knowledgable camp staff. This year's spring break farm camp will have an emphasis in caring for and maintain our new flock of baby chicks!

The benefits of children engaged in outdoor, nature and garden activities include:

a sense of responsibility
leadership skills
the discovery of personal passions
team work
a deeper understanding of empathy and practical application
perseverance
knowledge of nutrition and health
a deeper understanding of self care and self expression
the feeling of accomplishment and empowerment
the understanding of life cycles and ecosystems
the ability and the practice of risk tasking

BASIC INFO

When:
March 23 - March 27
9:00am - 3:00pm

Ages:
5 - 10 years old

Week-long Session
$225

Extended Care Available
from 7:30am - 9am and 3:00pm - 5:30pm
Additional $75 (Optional)

PARKING

Please park in the lot behind the
First Church of Christ Scientist at
480 N. Fairview Ave.

From there you can walk
onto the farm at the South end of the parking lot,
up the driveway toward the farmhouse.

Please do not drive onto the Farm.
We will gather near the mulberry tree
across from the farmhouse.

SPRING BREAK REGISTRATION FORM

Parent / Guardian Information
Parent/Guardians Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Phone*
Child's Information
Child's Name*
First Last
Child's Age*
If your child has any allergies or dietary restriction, please list them below.*
Is there anyone else authorized to pick-up or drop-off your child (Friend, Nanny, other Parent)?*
- yes
- no
Authorized persons name*
Has your child attended a program at the farm in the past?*
- Yes
- No
Is there anything else you would like to share about your child?
Waivers and Liability Information
Insurance Company*
Policy/Group Number*
Local Emergency Contact*
Emergency Contact Number*
Relation to Child
Video & Photo Release
I hereby authorize The Center for Urban Agriculture at Fairview Gardens (CUAFG) and those acting pursuant to its authority to photograph, video tape, or use any other electronic method of recording my likeness and/or voice to be used at CUAFG’s discretion in Fairview Gardens publications and/or web sites. The photographs and/or video footage will not be digitally manipulated to change its content.

I hereby give CUAFG the absolute right and permission, without restrictions, to make, copyright, and/or use, re-use, or publish said photographs/video footage of me in which I may be included in whole or in part, and waive any right to inspect and/or approve the finished printed materials, videos and/or web sites where my image appears. I further consent that my name and identity may be revealed therein or by descriptive text or commentary.

I release CUAFG and those acting pursuant to its authority from liability for any violation of any personal or proprietary right I may have in connection with such use. I understand that all such recordings, in whatever medium, shall remain the property of CUAFG.

I waive any right to compensation for my appearance in these printed documents, videos or web sites in any and all future uses of the photographs and/or video footage.
I consent to the Video & Photo Release Above*
- Yes
- No
Medical and Liability Release*
I agree to the Medical and Liability Release.
In consideration for being accepted by FAIRVIEW GARDEN/THE CENTER FOR URBAN AGRICULTURE to participate in the below described program, we (I) [and on behalf of our (my) child-participant] do hereby release, forever discharge and agree to hold harmless FAIRVIEW GARDEN/THE CENTER FOR URBAN AGRICULTURE and the staff thereof from any and all liability, claims or demands for personal injury, sickness, or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the child-participant that occur while said child is participating in the Fairview Gardens Youth Programs.

Furthermore, we (I) [and on behalf of our (my) child-participant] hereby assume all risk of personal injury, sickness, death, damage and expense as a result of participation in recreation, including tree climbing, and/or work activities involved therein. I authorize the staff of Fairview Gardens to act for me according to their best judgment in any emergency requiring medical attention. I understand that I will be financially responsible for all charges and fees incurred in the rendering of said emergency treatment, regardless of whether or not my medical insurance would cover such charges and fees. I further understand that I am required to maintain and carry accident insurance coverage for the child listed on this application, and verify that the coverage information that I have provided is accurate and true. I have no knowledge of any physical impairment that would be affected by the above named camper’s participation in the camp program as outlined in the brochure. I also understand that the Fairview Garden program's retains the right to use for publicity and advertising purposes, photographs of children taken at the farm. Further, authorization and permission is hereby given to said program to furnish any necessary transportation, food and lodging for this participant.

The undersigned further hereby agree to hold harmless and indemnify said FAIRVIEW GARDEN FARM/THE CENTER FOR URBAN AGRICULTURE, its administrators, employees, for any liability sustained by any other participant as the result of the negligent, willful or intentional acts of this participant, including expenses incurred attendant hereto.

We (I) are the parent(s) or legal guardian(s) of this participant, and hereby grant our (my) permission for him (her) to participate fully in said program.
Refund Policy*
I agree to these policies.

CAMP REFUND POLICY

A refund will be issued if requested by March 9th, minus a $35 administrative fee. After March 9th, no refunds for camp registrations will be issued. Camp is rain or shine. We will utilize warm/dry spaces on the farm and have fun incorporating the rain into our program. No refunds for rainy days.
Add Extended Care +75.00*
Selecting extended care will provide early and late drop off/pick up Monday - Friday from 7:30-9am and 3:00-5:30pm.
SPRING BREAK CAMP*
Price: $225.00
Financial Assistance Fund! (Enter an amount below.)

If you would like to help us offer our programs to more families who might need financial assistance, please consider adding on an amount here.
Total
$0.00
Total cost for Spring Break Camp.
Credit Card*

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
Parent/Guardian Signature*
I agree to the above terms and conditions.

SPRING BREAK CAMP 2020

ABOUT THE SPRING BREAK CAMP AT FAIRVIEW GARDENS

BASIC INFO

PARKING

SPRING BREAK REGISTRATION FORM

Parent / Guardian Information

Child's Information

Waivers and Liability Information

CONNECT WITH us!

CONTACT INFO

QUICK LINKS

ON THE FARM