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Farm Safety: Progressive Agriculture Safety Day

Name: Farm Safety: Progressive Agriculture Safety Day
Start: 2023-10-27T09:00:00-03:00
End: 2023-10-27T14:30:00-03:00
Location: Berwick & District Volunteer Fire Department

October 27, 2023 @ 9:00 am - 2:30 pm

Progressive Agriculture Safety Days:

Are for youth ages 7 to 13
Are filled with fun, hands-on activites to learn about farm safety
Are for those who live on, work on or visit farms
Include snacks, lunch, a t-shirt and a take home bag to share with families
Are only $10 per participant or $20 per family
Are presented by Farm Safety Nova Scotia and the Progressive Agriculture Safety Foundation
On a school in-service day
Fun!

For information contact info@farmsafetyns.ca or call 902-893-2293.

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Progressive Agriculture Safety Day Registration

Name of Participant
Participant's age
Grade in School
T-shirt Size (Please specify Youth or Adult)
Address

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands
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
Health Card Expiry Date

Year

Month

Day
Please list anything we should be aware of to help make your child's experience the best (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 Oct 13th – participants name entered in a prize draw!
Final Registration date is Oct 20th.
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 on this application 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.
Original Signature of Parent or Guardian (Can be completed on Safety Day)
Printed Name of Parent or Guardian
Date
Safety Day Code 23-2117

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Details

Date:: October 27, 2023
Time:: 9:00 am - 2:30 pm
Website:: https://farmsafetyns.ca/event/progressive-agriculture-safety-day-4/

Venue

: Berwick & District Volunteer Fire Department
: 300 Commercial Street
Berwick, Nova Scotia B0P 1E0
: View Venue Website

Organizer

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

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