Fall/Winter Planning Event

Child Registration + Permission Form

September 5, 2026 at 1524 Lady of the Lake Rd. Saint Martinville, LA 70582

Complete the form below to get started.

Child Information

Child's First Name

Child's Last Name

Age

Parent/Guardian Information

Parent/Guardian Name

Parent/Guardian Phone Number

Emergency Contact (if different than Parent)

Emergency Contact

Phone

Medical Information

Allergies or Medical Concerns

Photo Permission

My child may be photographed or recorded for Plow & Pulse Foundation social media, website, and promotional materials.

Yes

Permission and Acknowledgement

I give permission for my child to participate in the Plow & Pulse Foundation Fall/Winter Garden Planting event. I understand activities may include gardening, hayrides, fishing, interacting with farm animals, hands-on science activities, and other supervised outdoor activities.

Parent/Guardian Signature

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Date

Month

Day

Year