TOUR Application

Farm School Learning Pod Tour Application and Questionnaire

After receiving the completed tour application, we will reach out to you to schedule a date and time for your tour.

PLEASE NOTE: All tours take place on Mondays - Thursdays in between the hours 1:00pm - 2:30pm. Tours typically last 30 minutes in length. We ask that, if possible, you bring your child with you during the tour.

Please provide as much information as possible.

This application is for: *

Early Childhood (age 4-7) Learning Pod Elementary (age 7-10) Learning Pod After School (age 8-12)

What attendance option(s) were you interested in? (Select at least one) *

Early Childhood 4 days per week: Monday-Thursday, 8am-1pm Early Childhood 2 days per week: Monday & Tuesday, 8am-1pm Early Childhood 2 days per week: Wednesday & Thursday, 8am-1pm Elementary 2 days per week: Wednesday & Thursday. 8am-1pm Elementary 1 day per week: Wednesday, 8am-1pm Elementary 1 day per week: Thursday, 8am-1pm After School 2 days per week: Tuesday & Thursday, 3:30pm-5:30pm

* Indicates required field

Child's Name *

Sex Male or Female *

Male Female

Date of Birth mm/dd/yr *

Parent Name *

First

Last

Occupation *

Phone Number *

Email *

Parent Name *

First

Last

Occupation *

Phone Number *

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Person to Contact in case of Emergency *

Phone *

In accordance with Texas HB 262 and Texas Law Chapter 75, I understand that under Texas Law (Chapter 87,Civil Practice and Remedies Code) an equine professional or a farm animal professional is not liable for an inury to or the death of a participant in equine activities or frarm animal activities resulting from the inherent risks of equine activities and farm animal activities. I hereby release One Acre Farm, One Acre Farm Educational Foundation, any staff, and volunteers, from any liability due to injury or death of a participant in equine or farm animal activities. Yes or No *

Choose One *

Yes No

We appreciate that you answer each question thoughtfully and honestly. This helps us get to know your family and helps us better assist your child.

(Early Childhood) Has your child ever attended a daycare, pre-school or MDO type program before? If so, at what age and for how long? *

(Elementary) Has your child ever attended a preschool, private school, public school, homeschool before? If so, at what age and for how long? *

Why are you interested in having your child attend our "Farm School" Learning Pod? *

What are some of your child's interests? *

What are some challenges for your child? *

Does your child have any fears or aversions? *

Please explain a typical and summarized schedule of your child's day? *

What are some goals that you have for your child? (Long or short-term) *

Does your child have siblings? If so, what are their names and ages? *

How do you deal with conflict or behavioral challenges? (No judgement here!) *

(Early Childhood) Is your child toilet trained? (i.e. can use the toilet independently) If no, please explain what your child needs assistance with. *

Does your child have any allergies or dietary restrictions? If so, what are they? *

Does your child have any neurological differences? (autism, sensory-processing disorder, ADHD, etc...) And if so, what are some typical supports you provide for your child during challenges? Note: Sharing this information DOES NOT disqualify your child from our program - it simply helps us understand how we can best support your child. *

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