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Roots of Resilience New Rancher Camp Registration July 2018

We are very excited to have you sign up for Roots of Resilience’s New Rancher Camp.

Please fill out the information on this form, then click the “Register and submit payment” button to enter your payment information. Contact us at info@pnchm.org if you need to pay by check.

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Enter default event name for this form. This field is hidden and is used to pass the event name to LGL.

Workshop dates for inclusion in confirmation email
Workshop Registration Information
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First Name
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New Rancher Camp participants must be at least 18 years old to attend.
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Please enter your employer or farm or ranch name, if applicable.
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Cancellation Policy

Your registration may be transferred to another individual meeting the admission requirements with notice to Roots of Resilience at any time prior to 24 hours before the start of the camp. However, there may not be enought time for special diet and other considerations.

Registration may be refunded at 50% of the the registration fee paid if notice is given at least 30 days prior to the start of the camp.

Registration may be applied to a later camp if notice is made within 14 days prior to the start of the camp.

No refund will be made within 30 days of the beginning of camp.

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Your donation will help support the development of the New Rancher and New Cowgirl Camps and will keep them affordable and accessible for more participants.

Roots of Resilience, Prescott, WA, is a 501(c)(3) organization, EIN 46-4181977. Donations are tax deductible as allowed by law. We are registered with the Washington State Secretary of State’s office under the Charitable Solicitation Act, registration no. 39190. Additional info is available at the Charities Program, 1-800-332-4483 or www.sos.wa.gov/charities. We are registered as a charity with the State of Oregon, registration no. 107006199.

Please tell us about yourself
Your answers will help us tailor New Rancher Camp for you. Thank you.


Please tell us about your goals for attending New Rancher Camp.
Please check all that apply. This will help us learn how to reach more people. Thank you.

Waiver of Liability

WARNING

Under Washington state law, there is limited liability for an injury to or death of a participant in an agritourism activity conducted at this agritourism location if such an injury or death results exclusively from the inherent risks of the agritourism activity. Inherent risks of agritourism activities include, among others, risks of injury inherent to land, equipment, and animals, as well as the potential for you to act in a negligent manner that may contribute to your injury or death. We are required to ensure that in any activity involving minor children, only age-appropriate access to activities, equipment, and animals is permitted. You are assuming the risk of participating in this agritourism activity.

Acknowledgement of Possibility of Risk or Injury

As a participant in Roots of Resilience New Rancher Camp, I recognize the risk and acknowledge that there are certain risks of physical injury—including death, damages, property damage, or loss—which I may sustain as a result of participating in any and all activities connected with New Rancher Camp, or the use of the facilities or equipment.

I understand that a ranch environment has many inherent risk factors, including, but not limited to:

Chemicals and pesticides

Cold and sun/heat

Dust and pollen

Electricity

Hand tools

Highway traffic

Lifting

Livestock handling

Machinery and equipment

Mud

Noise

Ponds

Slips, trips, and falls

Small critters that can sting or bite

Tractors

Wells

I understand that it is my responsibility as a New Rancher Camp participant to be aware of and mitigate exposure to these and other risks inherent to New Rancher Camp participation.

Waiver of Claim for Injury

I agree to waive and relinquish all claims that I may have for injuries or damages as a result of participating in New Rancher Camp or using the facilities or equipment against Roots of Resilience and Matheson Farms LLC, and their officers, agents, servants, employees, owners, volunteers, and affiliates.

Release from Liability

I do hereby release and discharge Roots of Resilience and Matheson Farms LLC, and their officers, agents, servants, employees, owners, volunteers, and affiliates from any and all claims for injuries, including death, damages, property damage, or loss which may have or may in future accrue to me in account of participating in New Rancher Camp.

Indemnity and Defense

I further agree to indemnify and hold harmless and pay defense costs and defend Roots of Resilience and Matheson Farms LLC, and their officers, agents, servants, employees, owners, volunteers, and affiliates, from any and all claims resulting from injuries—including death, damages, property damage, or loss—sustained by me and arising out of, connected with, or in any way associated with the activities of New Rancher Camp or the use of facilities or equipment.

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For the safety of all participants, alcohol and drug use is not permitted during New Rancher Camp.
I hearby give to Roots of Resilience, its successors, or assigns, the right to reproduce in any of its printed and online publications (such as newsletters, annual reports, websites, social media posts, and blog posts) all pictures that it may produce of me during my participation in New Rancher Camp in any or all poses, authorizing them to use all such pictures and duplicates thereof for its publicity purposes and dispose of them as they may see fit.
Please check all boxes that apply to you. Thanks.