Agritourism Farm Admission Waiver Form
Please complete this waiver form before participating in activities on the farm. Read all sections carefully and acknowledge your understanding and agreement.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Name
*
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Please read and acknowledge the following waiver and release statement: By signing this form, I acknowledge that I am voluntarily participating in activities at the agritourism farm. I understand and accept the inherent risks associated with farm activities and agree to release and hold harmless the farm owners and staff from any liability for injury or loss.
I have read and agree to the waiver and release statement above.
*
Yes, I agree.
No, I do not agree.
Do you consent to photographs or video being taken during your visit for promotional purposes?
*
Yes, I consent.
No, I do not consent.
Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Participant Signature
*
Submit Waiver
Submit Waiver
Should be Empty: