2018 BLF Summer Registration
“Warning: Under Massachusetts law, an equine professional is not liable for injury to, or the death of, a participant in equine activities resulting from the inherent risks of equine activities, pursuant to section 2D of chapter 128 of the General Laws.”

You will need the date of your child's last tetnus shot to complete this form.

Email address *
Child's Last Name *
Your answer
Child's First Name *
Your answer
Birthdate *
Farm Program participants must be 5 to participate. 5 and 6 year olds are limited to half day Farm sessions. The Horse Program is for students 8 years and older.
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Grade in the Fall *
Your answer
Gender
Parent/Guardian 1 Name *
Your answer
Phone Numbers for Parent/Guardian 1 *
Your answer
Street Address or PO Box *
Your answer
City *
Your answer
State and Zipcode *
Your answer
Parent/Guardian 2 Name
Your answer
Phone Numbers Parent 2
Your answer
Email Parent 2
Your answer
Other Full Address
Your answer
Emergency Contact Name(s) *
Your answer
Emergency Contact Phone numbers *
Your answer
Authorized Pick Up - Please list name and phone number.
Your answer
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