Health Information
Release Statement
I hereby attest that all of the information provided above is correct and complete.
In event of injury or illness, I give the Learning Outside Staff and emergency/professional medical personnel permission to provide medical treatment for the participant listed above.
Hold Harmless Agreement Learning Outside offers outdoor learning programs on Triangle Land Conservancy’s Irvin Nature Preserve, 269 acres of pasture, forest and wetlands preserved in perpetuity by the Triangle Land Conservancy in Orange County. Program activities include art, science and other learning activities for both children and adults.
Activities in this program may include, but are not limited to: gardening, farm chores, interaction with goats, chickens and other farm animals as well as cats and/or dogs, drawing, painting, printmaking, other arts and crafts activities, nature crafts, singing, song writing, storytelling, dance, creative drama, puppet making, nature exploration, shelter building from natural materials, fire building, cooking, animal tracking, running games and other strenuous physical activity, archery, walking along the farm driveway to the pond, pond exploration and wading in the pond, hikes in the woods and to the creek, creek exploration and wading in the creek, work with woodworking hand tools and more.
Risks inherent in these activities include, but are not limited to:
- Exposure to biting insects, ticks, poison ivy, and poisonous snakes
- Exposure to diseases carried by ticks and other biting insects
- Walking, hiking, running and playing in hot or otherwise inclement weather
- Falls from climbing or slipping on pond banks, tree stumps, branches, & uneven terrain or tripping on rocks/stumps
- Injuries from use of sharp tools for carving, whittling, gardening and/or woodworking, or glue guns and allergic reaction from exposure to paints, paper mâché paste, cement, and other art materials during arts and crafts activities
- Burns from hot plate, camp fire, or hot food/liquids during cooking activities
- Drowning or injury while wading or playing in natural bodies of water
- Accidents on the driveway
- Risks normally associated with travel in a car driven by staff, hired drivers or the parent of one of the participants
I authorize Wendy Banning, Director of Learning Outside, as well as all paid and volunteer instructors in whose care my child has been entrusted, to lead the above named child in activities of the type listed above. I understand that there are risks inherent with the activities as well as with transportation to and from each area. I nevertheless voluntarily assume all risks of loss, damage or injury that may be sustained through my child's participation in programs offered by Learning Outside.
I agree to hold Learning Outside, Wendy Banning and all other instructors, volunteers, Learning Outside Board Members, Learning Outside Employees, and hired drivers as well as the Triangle Land Conservancy harmless for injuries, loss, or damage which may occur during such activities or while being transported to and from such activity.
The registration and payment receipts are not a guarantee of enrollment. All enrollments will be confirmed by personal email from Learning Outside to the parent/guardian. If a camp week over-enrolls, a refund will be issued.
NO REFUNDS FOR WITHDRAWALS:
I understand and acknowledge that Learning Outside reserves the right to cancel or postpone any of its programs, events, workshops, or gatherings of any kind scheduled to be held at the site for reasons including, but not limited to, safety concerns, weather, and community health risks without reimbursement for any session(s) missed.
