SUMMER DAY CAMP – ENROLLMENT FORM

Circle the camp date(s) you wish to enroll in:

June 16 - 19                              August 4 – 7

Information

Name:                                                                                                                                          

Address:                                                                                                                                       

                                                                                                                                                   

Riding Experience, if any (describe):
                                                                                                                                                   

                                                                                                                                                   

Accident/Medical Ins #:                                                 

Medications to be brought with child and a note explaining dosage.

Parent/Guardian Name:                                                                                                                 

Home Phone:                                                 Work Phone:                                                           

Parent/Guardian Name:                                                                                                                

Home Phone:                                                 Work Phone:                                                           

Age:                       T-Shirt Size:                 

Emergency Contact:                                                       Phone:                                                     

Email:                                                                                                                                          

In case of an emergency, we will use the Fairmont General Hospital unless otherwise specified here.

                                                                                                                                                   

How did you hear about Bunner Ridge Riding Association, Inc.?
                                                                                                                                                  

Cost:
The cost of the camp is $180.00 per four-day camp.  This includes two (2) hours per day of mounted instruction and three (3) hours of classroom and hands-on instruction.  Please make checks of $180.00 payable upon application.

Please send completed application and fee to:
     Bunner Ridge Riding Association, Treasurer
     Post Office Box 57
     Colfax, WV  26566