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Intern Registration Form 2021

Please take a moment and fill out this form to complete your registration. Thank you!

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Do you have any health conditions or allergies that we should know about in advance?

Do you have dietary restrictions and what are they

What are you most hoping to get out of this program?

How would you classify your own learning style?

I understand that this program is an unpaid educational opportunity and that my agreement to participate includes a release of all liability. I hereby agree to release Three Leaf Farm, LLC. (TLF) and it’s owners, directors, agents, insurers, employees, and volunteers from any and all claims and causes of action which I have now, or which may arise at any time in the future from any activity associated with TLF, including and without limitation the handling of any animal which occurs on the property owned by TLF, or in connection with any TLF operation, activity, or event. This includes all volunteer or guest activities, including farming and equine related. I understand that participation in farming, handling animals, wilderness activities, outdoor activities, have inherent risks. Through this release, I agree to extinguish all present and future claims against TLF arising from negligent or non-negligent activity or other torturous conduct including claims of injury or death of any person or animal, and damage or destruction of any property, vehicle, or equipment. This agreement and general release sets forth my entire agreement with TLF and fully supersedes any prior agreements or understandings between TLF and me. By signing this agreement, I acknowledge that I have entered into it voluntarily and with full opportunity for reflection and consultation.

COVID-19 Waiver: Three Leaf Farm will take all reasonable and practical measures to comply with current Covid-19 guidelines in Colorado. By attending events at Three Leaf Farm, I understand that to the extent not covered by insurance, I shall indemnify and hold harmless Three Leaf Farm, its owners, officers, directors, employees, agents, contractors, vendors, and affiliates against any and all liability, claims, actions, threats of actions, demands, expenses, attorneys’ fees, court costs, or losses of any kind or nature arising in relation for any reason, including but not limited to mistakes, errors, omissions, negligence, accidents, wrongful acts, intentional or willful acts, deficiencies in performance, breach of contract, or otherwise, and particularly with regard to the COVID-19 pandemic. T

By submitting this form, I affirm that I have read through the provided materials about the Herbal Internship, it's schedule, and it's guidelines and rules, and the submission of this form indicates my willingness and desire to participate in the program.

Signature

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