Homeschool Program Registration

Homeschool Education Program Registration

Dear Caregiver,
Below you will find the Registration, Liability Waiver, and Photo Release forms for the Huyck Preserve's Nature Exploration Program for Homeschool Students. Parents/Guardians please complete and sign where indicated the Registration, Liability Waiver, and Photo Release forms. If you have any questions, please do not hesitate to contact us by email ([email protected]) or phone (518-797-3440).

Location: Eldridge Research Center (284 Pond Hill Road, Rensselaerville, NY 12147) and outside
Dates: Spring 2025 4/11, 4/25/ 5/9, and 5/23
Time: 9:30-11:30am
Cost: $50 per student members, $70 per student nonmembers

Student Information

* Indicates required field

Student Name(s) *

Student Age(s) *

Parent/Guardian Information

Parent or Guardian Name *

First

Last

Parent or Guardian Email *

Parent or Guardian Address *

Line 1

Line 2

City

State

Zip Code

Country

Parent or Guardian Cell Phone Number *

Parent or Guardian Home Phone Number *

Please indicate which phone number is your preferred contact in case of emergencies *

Cell phone Home phone Other (fill in below)

Other phone numbers *

Relationship to student *

Special Requirements

Does your child have any restrictions or considerations that we should be aware of to ensure their fullest enjoyment of the program? Please describe these below, including any special accommodations necessary. Please note that it is your responsibility to supply any necessary medical equipment which relates to a specific medical condition. Please describe any and all considerations and special needs in the box below. If necessary, additional information can be included by sending an email to [email protected].

Comment *

Liability Waiver

In consideration of my/my child’s/children’s participation in the Nature Exploration Program for Homeschool Students at the Edmund Niles Huyck Preserve, Inc. and intending to be legally bound, I hereby waive, release and forever discharge any and all rights, actions and claims, either in law or in equity, which I or my heirs, executors or assigns may have against the Edmund Niles Huyck Preserve, Inc., their respective officers, directors, trustees, employees, volunteers, hosts, representatives, successors, assigns and affiliates (“releases”) for death, injury, loss, and any and all damages which may be sustained and or suffered in connection with my/my children’s/child’s participation in this program. The undersigned assumes full responsibility, and risk of, bodily injury, death or property loss that can occur due to participation program participant whether caused by the negligence of the Edmund Niles Huyck Preserve, Inc. or their officers, directors, trustees, employees, volunteers or agents or otherwise. The undersigned also understands that the Edmund Niles Huyck Preserve, Inc. does not assume any responsibility for or obligation to provide financial assistance or other assistance, including but not limited to medical, health, or disability insurance in the event of injury or illness. For good consideration, the undersigned hereby releases, discharges, and acquits the Edmund Niles Huyck Preserve, Inc., its successors, assigns and personal representatives from any claim or liability arising out of my/my children’s/child’s participation in the Nature Exploration Program for Homeschool Students.

Enter Today's Date *

Name *

First

Last

Check here to confirm you have read and agree to the Liability Waiver statement *

I agree

Photo Release

I give permission to the Edmund Niles Huyck Preserve, Inc. to use my student’s photo in publications, on its website, or other presentations to the general public. *

Yes No

PARENT/GUARDIAN NAME *

ENTER TODAY'S DATE *

Submit

Pay Online!*

After you submit your application, don't forget you can pay online with your credit or debit card. Find the button on the homepage for the Homeschool Program.

Please note: to receive Preserve member pricing, you will need to stop by the office, pay over the phone by credit card, or send your payment in the form of a check to the Preserve.