Garden Explorers Summer 2025 Student Name* First Last School (as of Fall 2025)* Grade (as of Fall 2025)*Select2 Grade3 Grade4 Grade5 Grade6 GradeSelect grade from dropdown.Date of Birth* MM slash DD slash YYYY I am registering for the following session(s):* Select All Session 1: August 4-8 Session 2: August 11-15 Session 3: August 18-22 Session 4: August 25-29 All sessions take place Monday through Friday, 9 am to 3 pm.My child has the following activity or medical restrictions. Please elaborate so that we may better meet your child's needs.Parent Name* First Last Parent Cell #*Email* Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Emergency Contact* First Last Please provide a contact OTHER than the parent listed above.Relationship to student* Emergency Cell #*Please tell us how you learned of this OSH program:Please feel free to share any other comments you may have.Release and Waiver of LiabilityWhile participating in activities at the Old Stone House each student is assumed to be voluntarily performing activities for which he/she assumes all risk, consequences, and potential liability. The undersigned hereby releases and holds harmless the Old Stone House and its agent or agents from any and all claims arising or resulting directly or indirectly from participation in the program. I authorize the Old Stone House to take necessary action in case of emergency if I am unable to be reached.* I agree to Waiver I authorize the Old Stone House to use photographs or recorded video in which my child appears, as well as art my child produces, in promotional literature, ads, displays, website or any format representing the activities. I agree to Waiver I am interested in financial aid Yes An application will be emailed to you.You will receive an email confirmation upon successful registration. Please contact us at education@theoldstonehouse.org if you do not.CAPTCHACommentsThis field is for validation purposes and should be left unchanged.
