Teen Boys Threshold Council

Teen Boys Threshold Council
Teen's Name

First NameLast Name
Teen's Birthdate

MonthDayYear
Date
Parent/Guardian Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian #2 Or Emergency Contact

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Please share a bit about your teen: what you would like for them to get out of this program, what you know about or imagine they are wanting and/or needing, or anything else you feel like sharing.
Are there any specific challenges your teen is facing that we should know about?
Below is the Fauna Forest Farm liability form. Please sign below before submission of this registration form. Thank you!
I fully acknowledge that participation in any and all programming and events at Fauna Forest Farm includes possible risks or hazards. I give permission for my child(ren), to attend Fauna Forest Farm programming. I also absolve and forever release Fauna Forest Farm, it’s teachers, director, property owners, affiliates, successors and assigns, officers, employees, representatives, partners, agents and anyone claiming through them (collectively, the “Released Party”) in their individual and/or corporate capacities from any and all claim, liabilities, obligations, promises, agreements, disputes, demands, causes of action of any nature and kind, known or unknown, which I may have or claim to have against Releasee or any of the Released Parties arising out of or relating to any injury, loss or damage to person and property that may be sustained as a result of participation in Fauna Forest Farm.

I understand that my child(ren)’s participation in Fauna Forest Farm involves inherent risks of physical or psychological injury, pain, suffering, illness, disfigurement, temporary or permanent paralysis and/or death, and I assume all related risks and do voluntarily permit my child to participate in Fauna Forest Farm.

I agree to indemnify the “Released Party” against any and all claims, actions, lawsuits, damages, and judgments, including attorney’s fee, arising out of or relating to my child(ren)’s participation in Fauna Forest Farm.

This Release for Participation in Fauna Forest Farm shall not be in any way construed as an admission by the “Released Party” that it has acted wrongfully with respect to me, my child or any other person, that it admits liability or responsibility at any time for any purpose, or that I have any rights whatsoever against the “Released Party”.

This Release shall be binding upon and inure to the benefit of the parties and their respective heirs, administrators, personal representatives, executors, successors and assigns. I have authority to release the Claims and have not assigned, or transferred any Claims to any other party. The provisions of the Release are severable. If any provisions are held to be invalid or unenforceable, it shall not affect the validity or enforceability or any other provision. This Release constitutes the entire agreement between the parties and supersedes any and all prior oral or written agreement between the parties concerning the subject matter of this Release. This Release may not be altered, amended or modified, except by a written document signed by both parties. The terms of the Release shall be governed by and construed in accordance with the laws of the State of Tennessee.
Parent/Guardian Name

First NameLast Name
Parent/Guardian Signature
Child's Medical Care & Health Information
Should my child(ren), become ill or suffer an accident of any character while he/she is in the care of Fauna Forest Farm, the directors or their employees shall make every effort to contact me immediately. In the event that Fauna Forest Farm is unable to reach me immediately, the directors and/or the designated employee(s) shall be authorized to secure and consent to such medical attention, treatment, and services for my child as may be deemed necessary by a licensed medical or healthcare professional. Any qualified person providing such required medical attention, treatment, or services may accept such consent as if given by me in person. I agree to assume responsibility for payment of all medical costs incurred.
Parent/Guardian Name

First NameLast Name
Signature
Donations to support the thriving and development of teen programming are gratefully accepted

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USDSuggested Donation $15-$30
Payment Methods

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Contact Info

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Teen Boys Threshold Council

Below is the Fauna Forest Farm liability form. Please sign below before submission of this registration form. Thank you!

Child's Medical Care & Health Information

Donations to support the thriving and development of teen programming are gratefully accepted

Payment Methods