top of page


Print & Sign

Waiver  And Acknowledgement of Release of Liability


In consideration for my visit to The Blossom Farm, the undersigned state and agree as follows:

By signing this waiver, I acknowledge that I am aware that under Virginia Law, there is no liability for an injury to or death of a participant in an agritourism activity conducted at this agritourism location (The Blossom Farm) if such injury or death results from the inherent risks of the agritourism activity. Inherent risks of agritourism activities include, among others, risks of injury inherent to land, equipment, and animals, as well as the potential I may act in a negligent manner that may contribute to my injury or death. I am assuming the risk of participating in this agritourism activity.

I also acknowledge that The Blossom Farm has taken reasonable steps to provide me with information to facilitate a safe visit, and I accept and understand that visiting a farming operation can be an activity involving risks of serious bodily injury or even death.  The risks include, but are not limited to:

  • Encounters with wildlife and farm animals, including dogs and cats

  • Changing weather conditions

  • Environmental features, including rocks, uneven paths, varying terrain and holes in the ground

  • Trip hazards such as cords, hoses, and irrigation lines

  • Farm equipment including but not limited to mowers, tractors, ladders, clippers, and various other equipment

  • The conduct of other visitors

In addition, I agree to the General Farm Rules posted on The Blossom Farm website, and included here:

  • Shirts and shoes must be worn at all times.  Walk carefully when out in the field.  We are a family operation & find it most respectful if shirts are worn.  The ground can be uneven or there may be holes, so we recommend shoes with good support & avoid wearing flip flops.

  • Appropriate family friendly styles & designs on apparel is required. 

  • Adults MUST supervise children in their party at all times.  Parties that do not supervise their children will be asked to leave for their own safety and the safety of our other guests.

  • Guests, including children, must stay in the parking area or the wildflower area.  Guests, including children, may NOT go into the woods, into the commercial growing zone, into the barns/buildings, into our home, or into the open meadow without prior authorization or an escort.  This is for the safety of our patrons. 

  • Guests, including children, must respect our pets, treating them kindly, and respect wildlife. Guests that are disrespectful of our pets or wildlife will be asked to leave for the safety of our pets and for the safety of all guests.  The general area is known to have bears, snakes, opossums, foxes, bees, wasps, hornets, ticks, spiders, fishers, coyotes, and other animals.  This general area is their native home, and humans need to act cautiously and respect the wildlife.

  • Do not run with scissors, clippers or other sharp objects. And do not run into tools, equipment or machinery.

  • Guns and firearms should be left at home.




Page 2 - Waiver  And Acknowledgement of Release of Liability



Names of underage members in my party, including all children, toddlers and babies aged 0 – 17 (please write name and age):

 By coming to The Blossom Farm, I acknowledge the inherent risks that come with being outside in wooded and farm environments, and agree to accept those risks for myself and children age 17 and under in my party listed below:





Signature of Adult accepting the risks of visiting The Blossom Farm for myself and children aged 0-17:

Signature: ______________________________________ Printed Name: ________________________ Date: _________


Signatures of other adults, aged 18+ in your party, accepting the risks of visiting The Blossom Farm:


Signature: ______________________________________ Printed Name: ________________________ Date: _________


Signature: ______________________________________ Printed Name: ________________________ Date: _________


Signature: ______________________________________ Printed Name: ________________________ Date: _________


Signature: ______________________________________ Printed Name: ________________________ Date: _________




Paid by:                □  Cash                □  Venmo           □  Credit Card          □  Paypal    



bottom of page