Fall Plant & Play Fridays 2026

Plant & Play Fridays!

The Youth Garden Project is offering an afternoon (1:00pm-3:30pm) program (September 4th- October 9th) for current 1st-6th graders. NOTE: This form will require you to make a deposit, please call the Youth Garden Project office at 435-259-2326 if you are unable to make the deposit now.
General Information
Camper First and Last Name:
Date of Birth:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Age:
Grade:
Pronouns:
NOTE: We request this information so we can best support your childs success and experience at camp.
Mailing Address:
Parent/Guardian (1) First and Last Name:
Parent/Guardian (1) Phone Number (include Cell, Home, & Work if applicable):
Parent/Guardian (1) Email:
Parent/Guardian (2) First and Last Name:
Parent/Guardian (2) Phone Number (include Cell, Home, & Work if applicable)
Parent/Guardian (2) Email:
Camp correspondence should be sent to:
The Youth Garden Project will provide a snack each Friday which is included in the registration fee. If you would like to opt out and have your camper bring their own food, please indicate below. NOTE: opting out of the provided snacks will not reduce the registration fee.
Emergency Contact Information
Emergency Contact #1 and Relationship to Child:
Contact #1 Phone Numbers (include Cell, Home, & Work if applicable!):
Emergency Contact #2 and Relationship to Child:
Contact #2 Phone Numbers (include Cell, Home, & Work if applicable!):
Individuals OTHER than Parents/Guardians Authorized to Pick-Up My Child; (include Cell, Home, & Work numbers if applicable):
Allergy & Medical Information
Health Insurance Provider and Policy Number (if none, write none):
List any allergies your child has to food, medications, insects, or other- this includes any dietary restrictions. If none, write none.
List any pre-existing medical conditions your child may have. For example: asthma, hearing, earing infections, visions, fractures or sprains, diabetes, seizures, fainting spells, heart issues, etc. If none, write none.
List any regular medications your child may take. If none, write none.
NOTE: YGP staff is unable to dispense ANY medication due to our liability insurance.
We want to make YGP programs as supportive and inclusive for your child as possible. Please list any behavior considerations that would be beneficial for YGP staff to know beforehand.
NOTE: We request this information so we can best support your child's success at YGP. Doing so will not affect your child's eligibility for camp.
ACCOMODATION REQUEST(S): If any, please share accommodation requests that would improve your child's experience at YGP.
NOTE: the Youth Programs Director may contact you to determine if YGP is able to fulfill the accommodation request and/or to discuss further how YGP could best support your child's YGP experience.
Parental/Guardian Releases
PARENT GUARDIAN AUTHORIZATION: I hereby declare my child to be physically sound, having medical approval to participate in the activities of the Youth Garden Project (YGP). This health history is correct so far as I know and the person herein described has permission to engage in all prescribed activities except as noted. I further understand that neither YGP nor any of its paid staff or volunteers can be held responsible in the event of an accident.
OFF GROUNDS AUTHORIZATION: I authorize that my child has permission to go off Youth Garden Project (YGP) grounds when necessary to participate in YGP activities, as some activities require the use of a facility or recreational area that is not available to them at the garden. I agree to hold neither YGP nor any of its paid staff or volunteers responsible for any accident or injury that may occur while my child is participating in a YGP activity that is off YGP grounds.
EMERGENCY AUTHORIZATION: I authorize any representative of the Youth Garden Project to seek medical attention for my child when immediate medical care is warranted by the circumstances and I cannot be reached, or if under the circumstances there is not time to attempt to reach me because of the nature of the injury or illness. I further authorize the health care professional selected by the agency to provide the necessary care and treatment for my child.
PHOTOGRAPHY/VIDEO AUTHORIZATION: The Youth Garden Project has my permission to use photographs/videos of my child in any promotional and/or social media material.
STUDENT RELEASE: In consideration of my child's participation in the Youth Garden Project (YGP) activities, I do hereby agree to hold free from any and all liability the agency and its respective offices, employees, and members and do hereby for myself, my heirs, executors and administrators, waive, release, and forever discharge any and all rights and claims for damages which I may have or which hereinafter accrue to me arising out of or connected with my child's participation in any of the activities of YGP.
PROGRAM VALUES AND RESTORATIVE PRACTICES

The activities, expectations, and decisions at YGP are intentional and driven by our core values of Community, Attitude, Respect, Empathy, and Safety (or C.A.R.E.S, as we like to call it). These values are connected to everything we do in our programs , and we expect participants and staff to uphold these values each day in their words and actions.

Ultimately, programs needs to be a safe and inclusive space for everyone. If a conflict ever becomes a safety concern, the Youth Programs Director will work with the families involved to determine the best course of action to keep everyone in our YGP community safe. We reserve the right to require an adult to come pick up a student whose behavior is posing risks to the safety and wellbeing of themselves or others, or is interfering with YGP operations.

If a student is barred from programs due to a safety concern, program tuition will not be refunded for the remainder of the program.
PAYMENT INFORMATION
- Cost for the program is $115 for the 6 weeks
- An initial deposit of $28 is due to hold your students spot.
- The remaining payment of $87 is due after you submit this registration form and recieve a confirmation email. To pay online, we will send you a payment link and a confirmation email after recieving the registration form. Cash or check payments can be mailed to the Youth Garden Project (530 Fourth E St) or dropped off in person.
- If you need to cancel registration for any reason, a refund will be contingent upon YGP's ability to fill your students spot.
- If we DO NOT recieve your full payment by August 28th, 2026 your students spot will be offered to the next person on the waitlist.
- Payment plans are available, a plan must be made with the Youth Programs Director by August 28th to hold your students spot.
I have read through, understand, and agree to all of the information shared throughout the 2026 Plant & Play Fridays registration form:

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Plant & Play Fridays Good Faith Deposit

This deposit will reserve your campers spot and will go towards the overall cost of the program.

$28.00 Quantity
Item subtotal:

Total

Debit or Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Should be Empty:

Plant & Play Fridays!

General Information

Emergency Contact Information

Allergy & Medical Information

Parental/Guardian Releases

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