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Registration Form
Child's Name:
___________________________________________ DOB: _______/_______/_______
Address:
___________________________ City ________________ State_________ Zip ___________
Parent's Name
________________________________
Phone Number (
) ________-___________
Riding Experience
______________________________Emerg
Contact Name _____________________
Emer Phone
( )
______-__________
Registering for:
(please circle)
FULL DAY CAMP
June 21 to 25 June 28 to July
2 July 5 to 9
July 12 to 16 July 19 to 23 July 26 to
30
Aug 2 to 6 Aug 9 to 10 Aug 16 to
20
Rules & Regulations
1-Camp
hours are between 9 am and 3 pm. All children are to be picked up
promptly. Children picked up after 3:15 will be charged an extra $2.50 for
each 15 minute delay
2-
Lunch is not provided. Each child should bring a bagged lunch to camp
daily.
3-
Clothing requirements: Each child is to wear or supply the following (each
day)
-
Riding
or bicycle helmet
-
No
child will be allowed to ride without a helmet and a low heeled shoe (such as
hiking or work boots) - Sneakers, sandals, clogs and the like are not
allowed for riding.
-
Clothing
appropriate for the weather. (long pants are required for the riding
portion)
4-
Silver Bit & Spur Farm reserves the right to expel any child who does not
follow the instructions and or rules as supplied by the instructor. They
also reserve the right to expel any child who knowingly and/or purposely
endangers anyone on the premises. Should your child be expelled from camp,
you will be notified immediately and you agree to pick up your child
immediately. Camp tuition is not refundable.
Approval
& Emergency Medical Release
I,
the undersigned, have read the Rules and Regulations above and give approval for
my child ________________________ (child's name) to participate in the horseback
riding camp and hereby waive, release and agree to hold harmless Silver Bit
& Spur Farm, owners of the farm property, and all instructors or persons
involved in this program, from any claim arising from injury to my child.
In my absence, I also give permission to perform any emergency medical treatment
for (child's name) ___________________ as deemed necessary by a physician as a
result of injury from participation in any camp activity.
$50
of the registration fee is Non-refundable
Signature
parent/guardian X__________________________________________ Date:____/____/____
Please list any known allergies or medical conditions
related to your child: _________________________________ ___________________________________________________________________________________________
___________________________________________________________________________________________
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