JUNIOR VETERINARIAN WORKSHOP
Please fill out this form to register your child for the JUNIOR VETERINARIAN WORKSHOP
Ages 6+ | Drop-off Only
Jan 9 • Feb 13 • Apr 17 • May 12
9:30am–1pm | $120 per class

Students learn animal anatomy, vitals, nutrition, health checks, and veterinary basics using real farm animals.. We would like to gather important information regarding the student and any specific needs they may have to ensure a supportive learning environment.

One form per student please.

Once this is completed you’ll need to make a payment with a link given or on the SUFS Website to secure your child’s spot.
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Email *
Student's Full Name & Any Nicknames *
Please enter the full name of the student. (Add any Nicknames)
Student's Date of Birth *
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Parent's Phone Number *
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Payment Options: *
Class Date Attending:
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Learning Concerns *
Please describe any learning concerns your child may have.
Medical Diagnoses *
Is there any medical diagnosis that would impact your child's learning you would like for us to be aware of? Please detail.
Does your child require any special accommodations? *
Please select one of the following
Please list any other information on your child you feel we should know or be aware of. *
Liability Waiver and Release Agreement  This Liability Waiver and Release Agreement (“Agreement”) is entered into by the undersigned individual (“Participant”), in favor of The Barn at Smith Acres, Daniel and Lindsay Smith, Warriors Community of SWFL Inc, and Smith Acres Homestead LLC, all located at 6470 Buckingham Rd, Fort Myers, Florida 33905 (collectively referred to as “Released Parties”). By signing this Agreement, Participant acknowledges and agrees to the following terms:  1. Acknowledgment of Risks  Participant acknowledges and understands that participation in agritourism activities, including but not limited to classes, volunteer opportunities, equine activities, animal husbandry, farming, and other related activities (“Agritourism Activities”) conducted at Smith Acres Homestead LLC, located in Southwest Florida (hereinafter “The Property”), involves inherent risks. These risks may include, but are not limited to, personal injury, property damage, illness, worms, parasites, ticks, fleas, mites, ecoli, or death caused by accidents, animals, natural elements, and the conditions of the land or equipment.  Participant further acknowledges that the activities involving equines (horses) are particularly dangerous, and participation in such activities is governed by Florida Statute 773.01-773.06 (the “Florida Equine Activities Statute”), which provides that an equine activity sponsor or professional is not liable for injury or death of a participant resulting from the inherent risks of equine activities, which are all activities since the equines are on property for each and every activity.  2. Assumption of Risk  Participant voluntarily and knowingly assumes all risks, both known and unknown, arising from participation in Agritourism Activities. Participant accepts full responsibility for their actions and any resulting injury or damage while on the Property. This includes for yourself and any minors accompanying you. Participants are fully responsible for the actions and safety of any minors accompanying.  3. Release and Waiver  Participant, on behalf of themselves, their heirs, executors, administrators, and assigns, hereby releases, waives, and discharges the Released Parties from any and all liability, claims, demands, actions, or causes of action that may arise from Participant’s involvement in Agritourism Activities, including but not limited to injury, death, property damage, or economic loss.  This release and waiver applies to all claims of negligence, whether caused by the actions or inactions of the Released Parties, including any claims arising from the ordinary negligence of any of the Released Parties, in accordance with Florida Statute 570.96 (Florida Agritourism Statute), which provides that agritourism operators are generally not liable for injuries resulting from the inherent risks of agritourism activities.  4. Indemnification  Participant agrees to indemnify, defend, and hold harmless the Released Parties from and against any and all claims, damages, losses, liabilities, costs, and expenses, including attorney’s fees, arising from or related to Participant’s, and/or accompanying minor(s) participation in the Agritourism Activities, whether caused by Participant’s negligence or otherwise.  5. Medical Treatment  Participant authorizes the Released Parties to obtain emergency medical treatment on Participant’s behalf if necessary. Participant agrees to bear all costs of such treatment and to indemnify and hold harmless the Released Parties for any injury or damage arising out of or connected with the provision of medical services.  6. Photography/Video Release  Participant grants permission to the Released Parties to take and use photographs, videos, or other recordings of Participant during the Agritourism Activities for promotional or educational purposes without compensation.  7. Applicable Law and Jurisdiction  This Agreement shall be governed by and construed in accordance with the laws of the State of Florida. Participant agrees that any legal proceedings arising out of this Agreement or Participant’s participation in Agritourism Activities shall be brought exclusively in the courts located in Lee County, Florida.  8. Severability  If any provision of this Agreement is held to be invalid or unenforceable by a court of competent jurisdiction, the remaining provisions shall continue to be fully enforceable.  9. Entire Agreement  This Agreement constitutes the entire understanding between the parties and supersedes any prior agreements or understandings, whether written or oral, relating to the subject matter hereof.  BY SIGNING BELOW, THE PARTICIPANT ACKNOWLEDGES THAT THEY HAVE READ AND UNDERSTAND THIS AGREEMENT, THAT THEY UNDERSTAND THE NATURE OF THE ACTIVITIES, AND THAT THEY ARE AWARE OF THE LEGAL CONSEQUENCES OF SIGNING THIS AGREEMENT, INCLUDING THAT THEY ARE WAIVING CERTAIN LEGAL RIGHTS. **I UNDERSTAND AND AGREE THAT THE ADULT NAMED IS RESPONSIBLE FOR ANY BEHAVIORS, ACTIONS, AND DAMAGES OCCURRED BY MINORS OR CHILDREN THEY ARE ALLOWING TO ATTEND ANY EVENT OR CLASS AT SMITH ACRES HOMESTEAD. *
Signature Here
Please check this box that you completely understand that you are responsible for yourself and any minors accompanying you or dropped off while present at the property of 6470 Buckingham Rd, Fort Myers, FL 33905, an equine facility with large and small animals, several livestock guardian dogs, and livestock, and is a working farm. This may include exposure to animals mating, structures or fences being moved or worked on, and the use of electric fencing. Hand washing is highly encouraged frequently to prevent the spread of diseases & parasites. *
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