2019 Overnight Camper Registration Form

Camper Name *

First Name Last Name

Gender *

Male Female

Grade *

Age as of July 1st *

Birthday *

Date

Family Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Please select all attending sessions for your camper.

Session #1

Session 1: June 30th to July 12th *RIDING PROGRAM FULL FOR 2ND WEEK* Session 1A: June 30th to July 5th Session 1B: July 7th to July 12th *RIDING PROGRAM FULL*

Session #2

Session 2: July 14th to July 26th *RIDING PROGRAM FULL* Session 2A: July 14th to July 19th *RIDING PROGRAM FULL* Session 2B: July 21st to July 26th *RIDING PROGRAM FULL*

Session #3

Session 3A: July 28th to August 2nd

Parent #1/Guardian#1 Name *

First Name Last Name

Parent #1/Guardian#1 Phone *

Area Code Phone Number

Parent #1/ Guardian #1 Email *

Parent #2/Guardian #2 Name

First Name Last Name

Parent #2/Guardian #2 Phone

Area Code Phone Number

Parent #2/Guardian #2 Email

example@example.com

Payment *

Deposit *Balance due in full April 1st 2019 Payment in Full

How did you hear about The Hollows Camp *

If "Other" selected above please describe.

Camper would like to horseback ride? RIDING PROGRAM IS FULL FOR SESSION 1 2ND WEEK, SESSION 1B, SESSION 2, SESSION 2A and SESSION 2B *

YES NO

HORSEBACK RIDING program includes: daily riding lesson, safety around horses, stable management, education on grooming, feeding and proper equestrian care. Please note that in order to maintain our exceptional teaching ratio (beginners 1:1, intermediate 1:2, advanced 1:3) our riding program is limited to 30 campers per session.

Camper will participate in Paintball Program? CAMPER MUST BE AGED 10 YEARS OR OLDER TO REGISTER AND PLAY PAINTBALL. *

YES NO

PAINTBALL program Includes:Safety course/Map walk through, Equipment rental/training & target practice, 2-5 games, 100 paintballs.

CAMPERS MUST BE AGED 10 YEARS OR OLDER TO REGISTER AND PLAY IN THE PAINTBALL PROGRAM