Name *

First Name

Last Name

Phone Number *

(###)

###

####

Please select how you would prefer to be contacted *

Email

Phone Call

Text Message

Is the Applicant a Minor? (Under 18) *

Yes

No

Student? *

Yes

No

Monday-Friday between 9a-12p

Saturday between 9a-12p

Date *

Please select your first available date to volunteer

MM

DD

YYYY

Do you have any physical conditions that may limit your activities? *

Yes

No

Liability Waiver

Animals can be unpredictable. Please do not handle animals without proper training or assistance. By your participation in the program you have indicated that you accept the limits of liability from inherent risks of animal behaviors. I understand and acknowledge that an agritourism entity is not liable for any injury to or death of an agritourism participant resulting from agritourism activities. I understand that I have accepted all risk of injury, death, property damage, and other loss that may result from agritourism activities.

I understand and agree

Date *

MM

DD

YYYY