Moving and Grooving in the Garden - Pro-Rated for 4 classes

LMHC & Creative Arts Therapist Marina Strauss will bring her beloved “Moving and Grooving” program to the farm this spring! Move, wiggle, dance and explore with your little one. We will use props and enjoy moving and having fun in the natural and beautiful environment of the farm. Weekly animal visits included.

Moving and Grooving in the Garden (6 weeks)

Wednesdays, 10:45-11:30am: 3/20, 3/27, 4/10, 4/ 24, 5/1, 5/8, (rain date: 5/15)

Members: $110, Non-Members: $120

Members: $75, Non-Members: $80

*Cancellation/Refunds: Tuition refunds are guaranteed up to 4 weeks prior to the start date of a program minus a $20 administrative fee. Please see our website for more details regarding payment policies.

Child's Name

First Name

Last Name

Age

Please enter the child's age

Birthday

Please enter the child's birthday

Parent/Guardian Name

First Name

Last Name

Phone

Verify Email

Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Email (optional)

If you would like an additional person to receive email updates regarding this class

Verify Email

Caregiver providing drop-off/pick up (If not parent/guardian listed above)

First Name

Last Name

Pro-rated Amount (4 classes)

$80 - Non-member

Pro-Rated Amount (4 classes)

$75 - LexFarm Member

Any notes to share with your teacher?

LIABILITY RELEASE AND WAIVER

Please read this Liability Release and Waiver (“Waiver”) carefully before signing it. This Waiver affects your legal rights.

Before participating in any program, class, or activity (“Activity”) sponsored by Lexington Community Farm Coalition, Inc., a Massachusetts corporation, together with its employees, volunteers, representatives, officers, agents, and members, and optionally in conjunction with Silk Fields Farm, LLC, together with its owners (members of the Goldinger family), volunteers and representatives (collectively, “LexFarm”), each participant must read, understand, and sign this Waiver (or, if under 18 years of age, have his/her parent or legal guardian sign it on his/her behalf).

SAFETY
I understand that an Activity may be offered by LexFarm or a LexFarm educational partner and may be overseen and directed by the educational partner’s personnel. I understand that I have a responsibility to follow the instructions of LexFarm and/or LexFarm educational partner’s personnel. I have read and understood all of the informational materials provided to me. I agree to pay attention to all signs located on the premises and abide by their instructions and warnings.

I understand that participation in an Activity sponsored by LexFarm or a LexFarm educational partner may include contact with animals, which may pose the risk of physical injury or other harm to myself, to the animals, or to others. I further understand that farms and farm equipment are inherently dangerous. I also understand that Activities sponsored by LexFarm or a LexFarm educational partner may be located on farmland or in other outdoor spaces and that engaging in such Activities may pose the risk of physical injury or other harm. I also understand that part of the risk involved is dependent on my own state of fitness or health and the awareness, care and skill with which I conduct myself in the Activity.

I have voluntarily read this warning, understood this warning, accept and assume all of the risks inherent or otherwise of participating in an Activity.

By signing this Waiver, I agree to release LexFarm from any cause of action, right, or claim arising out of, connected with, or resulting from my participation in any LexFarm or LexFarm educational partner Activity. I assume the risk of any illness or injury that I may incur during my participation in that Activity. I understand and knowingly recognize that this Waiver is a contract with legal consequences, and I have been advised to read it carefully before signing it.

Participant Name (Child's Name)

First Name

Last Name

Participant Name (Adult's Name)

First Name

Last Name

I agree to all conditions of this waiver

I, the undersigned, am the parent or legal guardian of the participant, who is under 18 years old. By checking this box and entering my name below, I agree to all conditions of this waiver. *

Parent or Legal Guardian's Name

First Name

Last Name

Date

(mm/dd/yyyy)

PHOTO RELEASE

LexFarm often takes photographs to document its work and activities. LexFarm seeks your permission to publish in print, electronic, video, or any other medium, the likeness or image of each participant for the general promotion of LexFarm programming. Children's names will not be used in association with photos. If you consent to the publishing of such photographs, please print your name below. (If the participant is under 18 years of age, please print the name of parent or legal guardian.) If you do not consent, please leave this field blank.

Child's Name

First Name

Last Name

Photo Consent

I consent to the taking and/or publishing of my child's photograph and my photograph:

Parent or Guardian Name

First Name

Last Name

Date

(mm/dd/yyyy)

How did you hear about this program?

LexFarm website

My child's school

LexFarm Facebook page

Facebook group (non-LexFarm)

LexFarm Newsletter

Friend/acquaintence

Other

If you chose "Other," how did you hear about this program?