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Minor Release
Forms

Release and waiver forms for minor visitors and volunteers at The Refuge at Lyric Farm.

Release and Waiver of Liability for Minors

Read Full Release Details

Minor's Full Name

Parent/Guardian's Full Name

Email

Phone

Street Address

City

State

Zip Code

Emergency Contact Name

Emergency Contact Phone

Allergies or Medical Info

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Minor's Signature

Parent's Signature

Date

We agree to the terms of this release.

130 Stanphyl Rd. Uxbridge, MA 01569

The Refuge at Lyric Farm is a project of Players Philanthropy Fund, Inc., a Texas nonprofit corporation recognized by IRS as a tax-exempt public charity under Section 501(c)(3) of the Internal Revenue Code (Federal Tax ID: 27-6601178,ppf.org/pp). Contributions to The Refuge at Lyric Farm qualify as tax-deductible to the fullest extent of the law.

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