Camp Registration Form

Camper’s Name

First NameLast Name
Birth Date

MonthDayYear
Home Phone Number
Mobile Number
Email Address
example@example.com
Nickname
Primary Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Select Camp shirt size

SmallMediumLargeExtra-large
Please provide any medical or dietary restrictions you have
How did you hear about Camp?

Family Information
Parent/Guardian's Name

First NameLast Name
Contact Phone Number
E-mail Address
example@example.com

Emergency Contact Information
Emergency Contact Name

First NameLast Name
Emergency Contact Phone Number
Relationship to Student

In 300 words or less, please describe your horse experience

0/300

Type a question

Camp week 1 June 3-6Camp week 2 June 30- July 3Camp week 3 July 29- Aug 1
Should be Empty: