Roots of Resilience Cowgirl Camp Registration

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

Please fill out the information on this form, then click the “Register and submit payment” button to enter your payment information.

Items with a * are required.

Workshop Registration Information

Name

Prefix

First Name

Last Name

Suffix

Age eligibility

Cowgirl Camp participants must be at least 18 years old to attend.

Yes, I am over 18 years old.

Email address

Verify Email

Is this email for:

Home

Work

Other

Organization

Please enter your employer or farm or ranch name, if applicable.

Mailing address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Is this adresses for:

Home

Work

School

Other

Phone number

Is this phone number for:

Work

Mobile

Home

Tuition for Cowgirl Camp

$775

Yes! I would like to make an additional donation to support Roots of Resilience Cowgirl Camp.

$50

$100

$25

Your donation will help support the development of Cowgirl Camp and will keep Cowgirl Camp affordable and accessible for more cowgirls.

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 Cowgirl Camp for you. Thank you.

How would you rate your level of cowgirl skills and knowledge?

Beginner

Intermediate

Advanced

What else should we know about your experience?

What are your expectations for Cowgirl Camp? Anything else you would like to tell us?

Please tell us about your goals for attending Cowgirl Camp.

How did you hear about Cowgirl Camp?

Please check all that apply. This will help us learn how to reach more people. Thank you.

Email from Roots of Resilience

Roots of Resilience website

Roots of Resilience Facebook page

Savory Institute

Saw on a listserve or other email

Other

What other ways did you hear about Cowgirl Camp?

Email signup

I would like to receive email newsletters, event notices, and other information from Roots of Resilience.

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 Cowgirl 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 Cowgirl 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 Cowgirl Camp participant to be aware of and mitigate exposure to these and other risks inherent to Cowgirl 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 Cowgirl Camp or using the facilities or equipment against Roots of Resilience and the Lazy R Ranch, and their officers, agents, servants, employees, owners, volunteers, and affiliates.

Release from Liability

I do hereby release and discharge Roots of Resilience and the Lazy R Ranch, 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 Cowgirl Camp.

Indemnity and Defense

I further agree to indemnify and hold harmless and pay defense costs and defend Roots of Resilience and the Lazy R Ranch, 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 Cowgirl Camp or the use of facilities or equipment.

Please check here to indicate that you agree with the above Waiver of Liability. This is required to particiapte in Cowgirl Camp.

I agree to the above Waiver of Liability

Alcohol and drug use

For the safety of all participants, alcohol and drug use is not permitted during Cowgirl Camp.

I understand that alcohol and drug use is not permitted on Cowgirl Camp property. I understand that if I am impaired by alcohol or drugs, I will not be permitted to participate in Cowgirl Camp activities.

Photo, video, and social media release

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 Cowgirl 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.

Yes, you may use my image for publicity purposes

How did you become interested in attending New Cowgirl Camp?

Please check all boxes that apply to you. Thanks.

I would like to work on farm or ranch

I would like to own farm or ranch

I currently own or work on farm or ranch

I would like to know more about farm or ranch careers

It sounds like fun

Other

Yes, I would like to support Cowgirl Camp by adding 3% to my total amount to help cover payment processing fees.