Reiter Affiliated Companies
Please submit the following information to check-in and be entered to win one of many Farm Day prizes! The more locations you check-in at, the more chances to win! All information entered is confidential and will not be shared.
Sign in to Google to save your progress. Learn more
First Name *
Last Name *
What is the total number of guests in your group? *
List of full names of members in group *
Email Address *
Phone Number
What is your city of residence? *
How did you hear about Farm Day? *

FARM TOUR WAIVER AND RELEASE OF LIABILITY FORM

I understand that while Reiter Berry Farms, Inc. strives to provide a safe environment for all visitors, visiting a working farm operation and/or participating in on-farm activities involves certain inherent risks. Dangers or conditions that are an integral part of commercial farming production activities, include but are not limited to: (1) natural hazards and conditions of land, vegetation, and waters including surface and subsurface conditions; (2) chemicals, fertilizers, or other substances used on the farm; (3) bees, insects or other animals commonly found on commercial farms; and (4) ordinary dangers of structures or equipment normally used in farming or production operations.

I acknowledge that I am visiting Marti Ranch located in Santa Maria, CA. As part of my visit, I understand that I will be participating in a farm tour or on-farm activities which may include, but are not limited to, walking through farming fields, touching soil, plants, and fruit, viewing organic materials used for fertilization, and watching general farm operations. I understand that participation in these types of activities involves a certain degree of risk. I have carefully considered the risk involved and have given consent for myself and/or my child to participate in these activities. I understand that participation in these activities is entirely voluntary.

 I understand and agree that I and/or my child are participating in this farm tour voluntarily and at our own risk. The undersigned, for myself and for my heirs, executors, administrators, and assigns, agree to release, hold harmless and to indemnify the Released Parties (as defined below) from any and all claims, actions, damages, costs, expenses of any nature or liability arising out of my and/or my child’s participation in the tour or on-farm activities.

I, for myself and/or my family’s participation, understand that this release and indemnity includes any claims based on the negligence, action, or inaction of any of the Released Parties and covers bodily injury (including, without limitation, death), property damage, and loss by theft or otherwise, whether suffered by me either before, during or after such participation.

I declare that I and/or my family members are physically fit and have the skill level required to participate in the tour or on-farm associated activities.  

I authorize medical treatment for me, at my cost, if the need arises.

For the purposes hereof, the “Released Parties” are Reiter Berry Farms, Inc., its officers, employees, and agents, together with the parent, subsidiary, affiliated and related entities of each of them, and the trustees, officers, directors, employees, and volunteers of any of them.

I CERTIFY THAT I HAVE READ THIS DOCUMENT AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT AT MY OWN FREE WILL.

*

MEDIA RELEASE AGREEMENT: I grant permission to Reiter Affiliated Companies, LLC and Reiter Berry Farms, Inc., SEEAG and their agents and assignees, to take photographs, audio, or videos of myself and/or my child for promotional or publicity purposes (for example, brochures, web pages, newspapers, magazines, marketing, social media, or television news). I give unrestricted permission for images, videos, and recordings of myself and/or my child to be used in print, video, digital and internet media. I agree that these images and/or voice recordings may be used for a variety of promotional purposes and that these images may be used without further notifying me. I further acknowledge that I will not be compensated for these uses and Reiter Affiliated Companies, LLC and Reiter Berry Farms, Inc. will own the completed rights to the images, videos, and recordings, and to any derivative works created from them. I waive any right to inspect the uses of any printed or electronic copies. 

*
Would you like to be added to the Farm Day mailing list? (Subscribers are the first to hear about tours, news, and giveaways -- we promise not to overload your inbox!) *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Students for Eco-Education & Agriculture.