| Camper's Last Name | First Name and Nickname | Middle Initial |
| Street Address | ||
| City | State and Zip | |
| Home Phone | ||
| ( ) | ||
| Grade Completed by 6/01/08 | Birthdate Summer Age | Gender |
/
/ |
M F | |
| Parent/Guardian's Full Name | Spouse's Name | |
| Home Phone | Business Phone | |
| Street Address | ||
| City | State and Zip | |
| Parent's Email Address | ||
| CAMP CHOICES | ||
| Please number in order of preferences (3 or 4 weeks) | Please note if you would like Day Camp | |
| Overnight Camp | ( Mon -Thurs) Number in order of preference | |
| June 8-13 No campers | ||
| June 15-20 No campers | Call for day camp dates if you are interested | |
| June 22-27 Ages 9-12 Room for 3 more | Limited space still available in some weeks | |
| June 29-July 3 Short week ages 6-11 $280/week | ||
| July 6-11 Ages 12 - 16 Room for 4 more | ||
| July 13-18 | ||
| July 20-25 Ages 6-11 Room for 1 more | ||
| July 27-Aug 1
Aug. 3-8 Ages 12-16 Room for 2 more Aug. 10-15 |
||
| Are you registering more than one child? | Please fill separate form for each. | |
| Please tell me a little about your child. | ||
| Any special needs? (eg. diet, asthma, behaviorial, | ||
| physical, or mental challenges, etc.) | ||
| Please tell me about your camper's horse knowledge. | ||
| Lessons? YES NO | ||
| Ability: NEW GOOD BETTER EXPERIENCED | ||
| Own a horse? YES NO DID HAVE ONE | ||
| Deposit: $100 Deposit per child required to register | ($50 non refundable once confirmed in a | |
| camp program) | ||
| Remainder due with camper | Remainder due with camper |
|