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Farm Safety: Progressive Agriculture Safety Day

Name: Farm Safety: Progressive Agriculture Safety Day
Start: 2022-11-14T09:00:00-04:00
End: 2022-11-14T14:30:00-04:00
Location: West Hants Sports Complex

November 14, 2022 @ 9:00 am - 2:30 pm

Progressive Agriculture Safety Day Registration – Nov 14, 2022

Name of Participant
Participant's age
Grade in School
T-shirt Size
Address

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

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Country
Phone
Email
Does the Participant
- Live on a farm
- Work on a farm
- Visit a farm
- None of the above
Emergency Contact
Phone
Health Card Number & Expiry
Please list any special needs for your child (dietary, allergies, mobility, behavioral, etc)
Registration Fee:
One ParticipantFamily

Paid by cash, cheque or money order made out to Farm Safety Nova Scotia, or by credit card by calling 902-893-2293.
Early bird registration by October 24th – participants name entered in a prize draw!
Final Registration date is November 7th.
Please complete a form for each participant, noting family members.
Consent
I have read and agree to the below information. [Note: If you do not give permission for all or part of items 2, 3, or 4 simply mark through and initial the statement(s) that you do not agree to. However, if you do not agree to item 1, your child cannot attend the Safety Day.]

1) I give my permission for the child listed below to attend the Progressive Agriculture Safety Day®. I understand that one of the purposes of the Progressive Agriculture Safety Day® is to teach participants to stay safe on farms, ranches and at home with a variety of age-appropriate lessons. During the Safety Day, safety barriers will be in place, safety rules will be enforced, and participants will be closely supervised by Safety Day instructors and group leaders. However, I acknowledge that there is the possibility of incidents. I release the coordinators, instructors, volunteers, sponsors, the Progressive Agriculture Foundation, and the Progressive Agriculture Safety Day® program from all claims, in the event of injury to my child, unless the injury is the result of gross negligence or willful misconduct on the part of these parties.

2) First aid will be available at the Safety Day and medical and/or hospital care will be provided in case of serious illness or injury. I understand that if serious illness or injury occurs the emergency contact(s) listed below will be notified. If it is impossible to reach the emergency contact(s), I give permission for emergency treatment as recommended by the attending physician.

3) I give my permission for photographs, audio, and video to be taken of my child while engaged in Safety Day activities and for these images to be used to promote safety in the media, social media, on websites, and in promotional materials.

4) I understand that my child might be asked to complete a written knowledge survey before and after the Safety Day to help evaluate the effectiveness of the Progressive Agriculture Safety Day® program. Participation is voluntary, and my child may choose not to participate; however, I give permission for my child to participate.
Signature of Parent or Guardian
Printed Name of Parent or Guardian
Date
Untitled

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Details

Date:: November 14, 2022
Time:: 9:00 am - 2:30 pm
Website:: https://farmsafetyns.ca/event/progressive-agriculture-safety-day-3/

Venue

: West Hants Sports Complex
: 16 Centennial Drive
Windsor, Nova Scotia B0N 2T0 Canada
: View Venue Website

Organizer

: Farm Safety Nova Scotia
Phone: 902-893-2293
Email: info@farmsafetyns.ca
: View Organizer Website

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