Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.1Enrollment2Family Information3Emergency and Liability4Permission5PaymentEnrollment * Summer Camp Fall Enrollment Tuition *You may enter a custom payment amount to pay half up front, pay for all siblings together, or make other arrangements. The default tuition is shown in the box.Minimum Price: $10.00Tuition *You may enter a custom payment amount to pay half up front, pay for all siblings together, or make other arrangements. The default tuition is shown in the box.Minimum Price: $10.00Preferred Summer Camp Start Date *July 6July 13July 20July 27August 3August 10Preferred Fall Semester Start Date *September 8 (Tuesdays)September 9 (Wednesdays)September 10 (Thursdays)NextStudent Name *Student Date of Birth *mm/dd/yyyyParent Name *Parent Phone Number *Parent Email *Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeIf you are attending with a friend, please list their name here. We will make every effort to ensure you are placed in the same farm camp or class.PreviousNextEmergency Contact Name *Emergency Phone Number *Medical Conditions or AllergiesI understand that participation in farm activities involves inherent risks including animals, tools, terrain, and outdoor conditions. I assume all risks and release Dewey Acres Farm School from liability. I authorize emergency medical care if needed. (Please type first and last name) *By typing your first and last name, you agree to these terms.PreviousNext from Stripe Tuition I give permission for Dewey Acres Farm School to use photos or videos of my child(ren) for educational, marketing, and promotional purposes (including website and social media). *Yes, I give permissionNo, I do not give permissionSignature *By typing your first and last name, you agree to these terms.Date *PreviousNextTotal$0.00Stripe Credit Card *Submit
