Farm Camp Registration 2013 **Week/s of camp attending: ____________________IMPORTANT! Child's Name__________________________________ Age_____Grade______School____________________ Mother____________________Father______________ Address_______________________________________________ Home phone________________________ Cell (emergency)_____________________ Email address_______________________                                           alternate email______________________                             (to keep informed of future camps and classes) Alternate Emergency contact #_________________________ Any Medical conditions/allergies/behavior problems ? List of people who can pick child up besides you-__________________________________________________ In case of emergency, I authorize medical treatment to be given by paramedics/hospital (including first response first aid/CPR by hosts) Parent’s Signature________________________________________ ........................................................................................................ ...................I have read the “equine activity law” (below) and consent to an adult led pony ride for my child. (State Requirement) Parent’s signature_______________________________ ....................................................................................................Circle treatments and otc meds I will allow my child to be given at  camp if absolutely needed:  Benadryl,  Advil, Tylenol, Neosporin, Topical anti-itch for bug bites- Benadryl topical, Aloe Vera or Tea Tree Oil, bug spray, suncscreen  Or circle  NONE Parent’s signature_______________________________________ .................................................................................................... Florida’s Equine Activity Law states: "An equine sponsor is not responsible for injuries from the participation of  equine activities. It is understood that equine participant knows that equine activities are inherently dangerous and you are at your own risk.”  (This is FL law to prevent lawsuits at major horseback riding facilities, your child will be led on a docile pony so don't fret!)............................................................................................ ....................................................................................................Payment and Refund Policy_______________________________________________________________________________________________ To register, please mail registration papers with check for 125.00, discount for siblings in immediate family is as follows: 115.00 for 2nd child, 3rd child is 105.00, and for 4th child, 95.00. ____________________________________________________________________________________________________ Fees are refundable with one month notice.______________________________________________________________________________________________ Checks can be made to Noah’s Ark  and sent  to:   Noah’s Ark Farm 12971 Tyler Run Ave  Odessa FL 33556 Please make a note that your check will not be cashed until the first day of camp, at which time all checks are deposited, regardless of whether child attends camp, unless one month notice was given. (This is for our accounting purposes.) What to bring: Every child should have play clothes on and close toed shoes/boots. Bring a back-pack with a change of clothes, bathing suit (or wear suit under clothes to make it easier.) Bring a towel and a cold, filled, water bottle with name, (I'll have refills). Pack a lunch that needs no refrigeration or put a cold pack inside. If your child does not eat a good breakfast, please pack a mid morning snack!! Spray children with Sunscreen and bug spray as needed before arriving to camp. Drop off is 9:30am  Pick up is 2:00 pm (Be prompt please, we have 6 children that need us after 2:00!) I don't have a set late fee for late pick-ups. Let's just say we don't want you to be late, and if it unavoidably happens, I need a treat!!! (lol) My cell phone on me at all times is 727/455-4985 Address  and Directions to the farm:   12971 Tyler Run Ave  Odessa FL 33556   From Tarpon Springs Rd.   If you are heading East, (from palm harbor) you will make a left on Tyler Rd, ½ past Brooker Creek ed. Center. If you are heading West on Tarpon Springs Rd, you will make a right on Tyler Rd, immediately after the Produce Market. In  .7 of a mile, Tyler veers sharply to the right. DON'T GO RIGHT. Instead, veer slight left and make quick left onto Tyler RUN. First mailbox and gate on right is 12971 Tyler Run. *** Open gate with gate code, 2-4-6-8 (it may already be open) and go down to playground behind house. (DO NOT TRY TO OPEN GATE MANUALLY IT WILL BREAK) We’ll meet there to begin each day before heading to the barn.   Bring you smiles and your hugs! Looking forward to a wonderful time with your child!   Thank you,   FARMER ROU AND FARMER BEN

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