Request edit access
Guest Sign-In and Liability Release Form
All guests, VISITORS and VOLUNTEERS, must sign this form while on-site at any Farmer Frog location.

Please STAY HOME if any of the following are true:
1) You have a Cough, Fever, or Shortness of Breath.
2) You have been exposed to someone with COVID-19 in the last 14 days.

If you have any questions, please contact us at:
www.farmerfrog.org
425-202-5753
grow@farmerfrog.org

Thank you and welcome to Farmer Frog!
Sign in to Google to save your progress. Learn more
Email *
Your Name *
Purpose of Visit *
For how many hours will you be here? *
How many people are in your group? *
Please select which site you are on *
GUEST SIGN-IN AND LIABILITY RELEASE
SIGN-IN AND LIABILITY RELEASE FOR VOLUNTEER OR VISITATION EVENTS AT ANY OF THE ABOVE LISTED SITES, IN SUPPORT OF Farmer Frog, Fresh Food Coalition, DairyLand LLC, Western Wildlife Outreach, NTEMC, NWTEMC and Light House Gardens and partners, IT SHALL REMAIN IN EFFECT FOR ALL PROJECTS SPONSORED BY THESE ORGANIZATIONS AND ANY EVENT HOSTED AND/OR ORGANIZED BY A PARTNER OF THESE ORGANIZATIONS, THAT BY SIGNING THIS FORM I AM ACKNOWLEDGING AND RELEASING Farmer Frog, Fresh Food Coalition, DairyLand LLC, Western Wildlife Outreach, NTEMC, NWTEMC, and Light House Gardens AND PARTNERS FOR ANY AND ALL LIABILITY IN THE EVENT YOU HAVE AN ACCIDENT OR SUSTAIN AN INJURY WHILE PARTICIPATING IN THE EVENTS AND/OR VOLUNTEER PROJECTS.

1) As a guest or volunteer for  Farmer Frog, Fresh Food Coalition, DairyLand LLC, Western Wildlife Outreach, NTEMC, NWTEMC and Light House Gardens and partners, I am a participant of an event and/or volunteer project hosted by them at BearGrass Farm, at the address of 11201 Old Snohomish Monroe Road Snohomish WA 98290.

2) As a guest or volunteer for  Farmer Frog, Fresh Food Coalition, DairyLand LLC, Western Wildlife Outreach, NTEMC, NWTEMC and Light House Gardens and partners, I am a participant of an event and/or volunteer project hosted by them at the STUDIOS, at the address of 12125 Treosti Road Snohomish WA 98290

3) As a guest or volunteer for  Farmer Frog, Fresh Food Coalition, DairyLand LLC, Western Wildlife Outreach, NTEMC, NWTEMC and Light House Gardens and partners, I am a participant of an event and/or volunteer project hosted by them at the FLOOR, at the address of 12129 Treosti Road Snohomish WA 98290

4) As a guest or volunteer for  Farmer Frog, Fresh Food Coalition, DairyLand LLC, Western Wildlife Outreach, NTEMC, NWTEMC and Light House Gardens and partners, I am a participant of an event and/or volunteer project hosted by them at Light House Gardens, at the address of 11305 Old Snohomish Monroe Rd , Snohomish, WA, United States, 98290

I may receive food that is provided to me without any charges or fees attached. In such a case, I understand that while they grow and collect safely grown and handled products, the food they give to me MUST BE STORED, and HANDLED by me. It needs to be transported, stored, processed, cooked and consumed according to the guidelines of our local and national health departments. They are gifting me this product. I understand that I am under no obligation to pay anything for this service. If I choose to donate toward the program it is a gift from me to Farmer Frog or Partners. Their team, including the drivers, loaders, and operators, are practicing the latest recommended industry BMPs and methods and follow the COVID related protocol, but they cannot guarantee that the site, food and any packaging is COVID-19 contamination-free. If product is loaded into my vehicle, by myself or staff, as a participant I understand that I am solely responsible for all the loads I deliver to or pick up from the site, including loss of loads, tipping, breakage, shifting or any other load and loading related issues.

I am also aware that some events and/or volunteer projects involve or adjacent to construction and maintenance of trails and recreation facilities, involve or adjacent to the livestock facilities, Farm Facilities, growing spaces, restored land, etc. For all events and/or volunteer projects at the project site, I understand that the participation in those events and/or volunteer projects poses certain dangers, including but not limited to the natural or unnatural hazards within these sites, using hand and motorized construction tools (and working in the proximity of such tools when used by others), danger in the vicinity of heavy duty equipment such as vehicles, box trucks, forklifts, etc., injury or illness in remote places without medical facilities, danger from livestock, and associated facilities, and the forces of nature. In consideration for permitting me to participate in projects sponsored by  Farmer Frog, Fresh Food Coalition, DairyLand LLC, Western Wildlife Outreach, NTEMC, NWTEMC and Light House Gardens and partners,  I shall hereby hold harmless, and indemnify  Farmer Frog, Fresh Food Coalition, DairyLand LLC, Western Wildlife Outreach, NTEMC, NWTEMC and Light House Gardens and partners, their officers, officials, employees and agents, from and against any and all claims, actions, suits, liability, loss, expenses, damages and judgments including costs and attorneys’ fees in defense thereof.
I understand that I need to wear appropriate Personal Protective Equipment as provided to me, wear the work gloves I brought with me, wear closed toe footwear and appropriate clean clothing as it suits the task. 
I acknowledge that I have read and I understand this document.
I acknowledge that I am welcome to wear a mask or face-shield, wear disposable gloves (if applicable), and observe social distancing but no one can guarantee that I am not getting exposed to COVID or other illness while I am participating in an event or volunteer project.
I also acknowledge that by participating at an event or volunteer project, I consent to the staff taking photos, videos, audio recordings, and any other digital recordings. This consent also includes releasing all rights and ownership of such media collected by the staff. This consent is assumed unless I express that I do not wish my picture taken and let a site supervisor know.
I have read and agree to abide by the terms stated above in this Liability Release form. *
Required
Parent or Guardian Name (if guest is under age 18)
Parent or Guardian phone number (if guest is under age 18)
Parent or Guardian Email (if guest is under age 18)
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Farmer Frog.

Does this form look suspicious? Report