WHR Farm Camp Registration

Camp Application Form

Camper Registration
Parent / Guardian & Emergency Contact
Responsibility and Release
Media Release
Payment

Camper Information

To apply multiple campers, press the plus(+) icon to the right of applicant form.

Additional campers are automatically discounted.

Camp Week Selection

Applicant Information

Child’s First Name	Child’s Last Name	Child’s Age	What School Does Your Child Attend?	What Grade is Your Child Entering in Fall 2025?	Does your child have any allergies?	Does your child have any dietary restrictions?	Does your child have any medical conditions we should know about? Please list any medication that will need to be administered during camp.	T-Shirt

Parent / Guardian

First Name

Last Name

Phone/Mobile

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Emergency Contact

First Name

Last Name

Relationship to Participant

Phone/Mobile

Please provide the name/s (as shown on State Issued ID) for anyone authorized to pickup the camper from camp, other than the parent/guardian listed above.

Farm Camp Responsibility and Release

As a parent or guardian of a child in the Farm Camp program, I wish to make clear my understanding that World Hunger Relief (hereafter referred to as WHR), 356 Spring Lake Rd, Waco, Tx 76705 does not assume any responsibility for loss of property, damage to the same, personal harm or illness that may occur; and I, for myself, my child, executors, administrators, distributes, and assigns, in considerations, do hereby absolve WHR and hold them harmless from any claim of demand which I or they might conceivably assert upon the basis of the foregoing.

WARNING: UNDER TEXAS LAW (CHAPTER 75A, CIVIL PRACTICE AND REMEDIES CODE), AN AGRITOURISM ENTITY IS NOT LIABLE FOR ANY INJURY TO OR DEATH OF AN AGRITOURISM PARTICIPANT RESULTING FROM AN AGRITOURISM ACTIVITY.

SUNSCREEN, BUG SPRAY, FIRST AID and MEDICATIONS RELEASE: I hereby grant permission to WHR. to administer sunscreen or bug spray to my child, as needed. I authorize WHR to administer first aid to my child, if necessary, including, but not limited to: bandages, antibiotic ointment, antihistamine, and itch cream. I understand that WHR will not dispense oral medications such as Tylenol, Advil, Aspirin, or any other oral medication (with the exception of antihistamines) without verbal consent from the parent or emergency contact of the child.

I concede that WHR has the right and authorization to administer Benadryl as an antihistamine and any emergency inhalers or EpiPens that I have checked in with my child. Further, I agree that WHR has the right and authorization to summon EMS and give authorization to EMS to perform services when deemed prudent or necessary by WHR staff or volunteers.

Terms Agreement

I have read and agree to the terms above

Please digitally sign your name to consent to our waiver and responsibility release:

Agreement #1

I will keep my camper home if s/he has had a fever or vomitting within 24 hours prior to Farm Camp

Agreement #2

I will agree to inform Farm Camp staff immediatealy if my camper exhibits symptoms of a contagious disease during the week of Farm Camp

Agreement #3

I will assure my camper is ready to spend the day outside in the sun (e.g. sunscreen applied; sun hat; appropriate clothing)

Agreement #4

I will make sure my camper has a water bottle each day

Agreement #5

I will assure my child is wearing closed toed shoes

Camper Information

Parent / Guardian

Emergency Contact

Farm Camp Responsibility and Release

Farm Camp Media Release

Payment