Medical Emergency Consent Plan
In the event that emergency medical aid/treatment is required due to illness or injury during activities, or while on the property of the agency, I authorize West Maple Farm to:
1. Secure and maintain medical treatment and transportation as needed.
2. Release participant records upon request to the authorized individual or agency involved in the medical emergency treatment.
This authorization includes x-ray, surgery, hospitalization, medication and any treatment procedure deemed necessary or “life saving” by the physician.
Rockland Agricultural & Farming Center Liability Release and Agreement for this Facility and Program
I hereby:
1. Hold West Maple Farm / Rockland Agricultural & Farming Center (RAAFC) ; its owners, employees, agents, and/or volunteers harmless for any and all injuries or illness incurred by myself, my minor children and any others that accompany me on said property. I shall bring no claims, demands, actions, causes of action and/or litigation against West Maple Farm and/or its associates or owners for any loss due to bodily injury or death sustained by me, my minor children, legal ward, in relation to the premises and operation of this facility, which includes handling, or being near animals.
2. Acknowledge and fully understand that I will be engaged in an activity that might result in serious injury including permanent disability or death, and severe social and economic loss. Not only by my action, inaction, or negligence, but also by the action, inaction and negligence of others, the rules of the sport/activity, or conditions of the premises or equipment used. Further, I acknowledge that there may be other risks not known to me or foreseeable at this time.
3. Understand that no pets other than the animals of West Maple Farm ( RAAFC) will be allowed on the property.
4. Understand and agree that anyone using this facility and/or parent/guardian will repair or reimburse West Maple Farm ( RAAFC) for all expenses which include materials and time in the event of any damage to equipment on the property.
5. Understand that West Maple Farm ( RAAFC) has permission to take and post any photos taken of my child during camp hours to their website & advertisements.
6. If my child is allergic to bees It will be my responsibility to make sure they have an EpiPen With them daily.
I have read this and understand that by submitting this form , and knowing this I sign it freely and voluntarily agree to participate and/or have my minor children participate, knowing conditions involved and do so of my own free will.