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2021 Needham Community Farm Waiver Form

Thank you for planning a visit to the Needham Community Farm!  Please choose the appropriate Waiver below.

Each Adult volunteer or visitor must fill out a Waiver.  If children/minor family member will be coming to the farm WITH adult, their names must be included on one or both of the parent waivers.

If Youth/Minor (age 17 or under) will be coming to the farm WITHOUT a parent or guardian, parent or guardian must fill out Waiver for them (choose Youth/Minor below).

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Youth/Minor Waiver
This section is for a Youth/Minor (under age 18) who will be coming to the farm with a group or as an individual volunteer. If the Youth/Minor will be coming to the farm with their family, please go back and selection "Adult or Family" option.
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First Name
Last Name

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Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code

Please enter in formation XXX-YYY-ZZZZ
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I would like to subscribe to the Needham Community Farm email list, for monthly Newsletters and other notifications.
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Please fill in the name of the CSL School - for example: Needham High School, Pollard Middle School, Nobles & Greenough, etc...
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Examples: Needham High School, Needham Steps Up, Nobles, Rivers School, etc...
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Examples: Needham High, Needham Steps Up, Nobles, Rivers School, etc...
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Parent/Guardian Information
Adult Information
Adult or Family Waiver
Each Adult planning to come to the Farm must fill out a waiver for themselves. Minor (under 18) family members should be included on one or both adult family member's forms. For Youth/Minor family members who will be coming to the farm without a parent or guardian (i.e. with a group or as a CSL volunteer) please go back to the top and choose "Youth/Minor".
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First Name
Last Name
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Emergency Contact Information
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Name (First and Last)
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Youth/Minor Release and Electronic Signature
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Needham Community Farm occasionally uses pictures and videos of volunteers and program participants on the Farm website and in printed material, videos, social media, and picture displays. Please read the following and choose an option.

By entering your name and today's date below, you are submitting an electronic signature for this consent form, release from indemnity, and the option you have selected above for the photo and video release.  This is the "Youth/Minor" Waiver.  If the Participant/Volunteer is age 18 or above, please fill go back to the top and choose "Adult or Family".

CONSENT FORM, RELEASE FROM LIABILITY & INDEMNITY AGREEMENT

I realize injuries can occur from participation in Farm programs. I hereby waive, release, absolve, indemnify and agree to hold harmless Needham Community Farm (“NCF”), including its contracted teachers, and the Town of Needham and its departments, officers, employees, and agents (collectively, "Needham") from any and all claims, damages, losses or expenses of whatever kind or nature which the above named Minor/Youth may have or acquire arising out of or resulting, directly or indirectly, from participation in NCF programs. I also RELEASE and discharge Needham from any and all claims, damages, losses or expenses of whatever kind or nature which the above named Minor/Youth may have or acquire arising out of or resulting from, directly or indirectly participation in NCF programs. I furthermore agree to defend and INDEMNIFY NCF and/or Needham against any claim, damage, loss or expense of whatever kind or nature that Needham may have to pay that arises from the intentional, grossly negligent, or reckless acts or omissions of the above named Minor/Youth while participating in NCF programs.

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First Name
Last Name
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(mm/dd/yyyy)
Adult/Family Section

The sections below will only be displayed for the Adult or Family Waiver.

Note that the Name and Email are collected above in the Parent/Guardian section.



Please include first and last names of each minor child, separated by commas.
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Please indicate the age(s) of the above Minor Children.
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Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
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I would like to subscribe to the Needham Community Farm email list, for monthly Newsletter and other notifications.
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Emergency Contact Information
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Name (First and Last)
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Adult or Family Photo Release and Electronic Signature
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Needham Community Farm occasionally uses pictures and videos of volunteers and program participants on the Farm website and in printed material, videos, social media, and picture displays. Please read the following and choose an option.

By entering your name and today's date below, you are submitting an electronic signature for this consent form, release from indemnity, and the option you have selected above for the photo and video release.  This is the "Adult or Family Waiver.  If the Participant/Volunteer is age 18 or above, please go back to the top and choose "Youth/Minor"

CONSENT FORM, RELEASE FROM LIABILITY & INDEMNITY AGREEMENT Copy

I realize injuries can occur from participation in Farm programs. I hereby waive, release, absolve, indemnify and agree to hold harmless Needham Community Farm (“NCF”), including its contracted teachers, and the Town of Needham and its departments, officers, employees, and agents (collectively, "Needham") from any and all claims, damages, losses or expenses of whatever kind or nature which I or the above named Family Member(s) may have or acquire arising out of or resulting, directly or indirectly, from participation in NCF programs. I also RELEASE and discharge Needham from any and all claims, damages, losses or expenses of whatever kind or nature which I or the above named Family Member(s) may have or acquire arising out of or resulting from, directly or indirectly participation in NCF programs. I furthermore agree to defend and INDEMNIFY NCF and/or Needham against any claim, damage, loss or expense of whatever kind or nature that Needham may have to pay that arises from the intentional, grossly negligent, or reckless acts or omissions of myself or the above named Family Member(s) while participating in NCF programs.

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First Name
Last Name
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(mm/dd/yyyy)