Name of Participant * First Name Last Name Minor Date of Birth (Volunteers under the age of 15 must be accompanied by an adult unless approved by Simple Sparrow staff beforehand.) MM DD YYYY Phone (###) ### #### Email Name of Parent/Guardian (If Participant is Under 18) First Name Last Name Event/Program (Check One): * First Saturday Care Farm Visit/Tour Volunteer Therapeutic Session Internship Other If Other, Please Specify Date of Visit MM DD YYYY Acknowledgment * 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 Signature of Participant/Guardian * If Under 18, Parent/Guardian's Signature Required Today's Date * MM DD YYYY Thank you for completing the form. General Liability Waiver
