The Soil Stewards Conservation Camp at Earth People Farms

Please complete this form to register for The Soil Stewards Summer Camp - July 6-10, 8am-12noon at Earth People Farms on St. Helena Island. All ages welcome, students younger than middle school must have parent/guardian present at all times. Activities include conservation career presentations, freedom farming history presentations, farm tours, seed starting, pollinator pictures, herb identification, and more. Participants will have the opportunity to earn a Soil Stewards and Earth People Farms patch at the end of camp.
Section 1: Participant Information

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1. Participant First Name (Required.)

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2. Participant Last Name (Required.)

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3. Participant Date of Birth
Date (Required.)

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4. Participant Gender (Required.)

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5. Participant Race/Ethnicity — select all that apply (Required.)

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6. School Name (Required.)

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7. Grade Level for Upcoming School Year (Required.)

Section 2: Parent/Guardian Information

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8. Parent/Guardian First and Last Name (Required.)

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9. Relationship to Participant (Required.)

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11. Parent/Guardian Phone Number (Required.)

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12. Emergency Contact Name (Required.)

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13. Emergency Contact Relationship to Participant (Required.)

Section 3: Health, Safety, and Accessibility

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14. Does the participant have any food allergies? (Required.)

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15. If yes, please list food allergies and severity. (Required.)

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16. Does the participant have any medical conditions, medications, or health concerns camp staff should know about? (Required.)

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17. Does the participant have any accessibility, mobility, learning, behavioral, or support needs we should be aware of? (Required.)

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18. Is the participant permitted to engage in outdoor farm-based activities, including planting, harvesting, walking on uneven ground, and supervised hands-on learning? (Required.)

## Section 4: Camp Registration Details

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19. Has the participant attended a farm, gardening, agriculture, or outdoor learning program before? (Required.)

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20. What is the participant most excited to learn or experience at Soil Stewards Summer Camp? (Required.)

Section 5: Referral Information

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21. How did you hear about Soil Stewards Summer Camp? (Required.)

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22. If an organization referred the participant, please list the organization name. (Required.)

## Section 6: Permissions and Consent

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23. I give permission for my child to participate in Soil Stewards Summer Camp activities. (Required.)

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24. I understand that camp activities may take place outdoors and may include supervised farm, garden, food, and nature-based learning experiences. I acknowledge that participation in outdoor activities involves ordinary risks, including slips, trips, insect bites, weather conditions, and minor injuries. By signing below, I voluntarily assume these ordinary risks and release Earth People Farms, its owners, employees, volunteers, and partners from liability for injuries or damages arising from ordinary participation in camp activities.

In the event of an emergency, I authorize camp staff to obtain appropriate medical care for my child if I cannot be reached immediately. (Required.)

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25. Photo/Media Release: I understand that The Soil Stewards and/or Earth People Farms may take and use photos or videos of the participant for program documentation, reports, social media, or promotional materials. (Required.)

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26. Parent/Guardian Signature (please type full name) (Required.)

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27. Date (Required.)

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