Day Camp Online Registration Form

(required fields are marked with an asterisk *)

*Student Name:                              *Male    *Female

Referred By:

*Level of Riding Experience:              None    Very Little    Novice    Intermediate

If any, briefly describe your child's riding experience:

Briefly describe your child's swimming experience:

 

*Does your child require any type of Personal Flotation Device:               Yes    No

If yes, what type:

(NOTE: If PFD is required it must be supplied by parent.)

*Age as of June 1:                     *Height:                     *Weight (lbs.):             

*Address:             

*City:                  *State:                  *Zip Code:             

*Home Phone:                    Work Phone:             

Cell Phone:                    Fax:             

E-Mail:             

Best Time To Call:

Any special requests:

If a riding helmet is needed please check here:

Please select session or sessions you are signing up for:

(Spring 2012 Session dates)

  Session Dates Check One
1 April 9 - 13 Full  Half

(Summer 2012 Session dates)

  Session Dates Check One
1 June 18 - 22 Full  Half
2 June 25 - 29 Full  Half
3 July 9 - 13 Full  Half
4 July 16 - 20 Full  Half
5 August 6 - 10 Full  Half
6 August 13 - 17 Full  Half
7 August 20 - 24 Full  Half
       

 

SPRING program runs Monday - Thursday 9:00AM - 4:00PM & Friday 8:30AM - 1:00PM

Weekly SUMMER programs run Monday - Thursday 8:30AM - 4:00PM & Friday 8:30AM - 1:00PM

Do you need morning or afternoon care prior to or after clinic hours?   Yes   No

(You may drop your child off as early as 8:00 AM and pick up as late as 5:00 PM for an additional fee of $40.00 per child per session. Friday afternoon extended care is an additional $20.)