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*Summer Riding Camp*
One week sessions beginning June 8th, for ages 6-14	M-F 9am-1:00 pm
Safe Horsemanship, Horse Care, Basic Riding Skills, Games and More!	Fee --$200
Summer Camp Application:

Name
Birth Date		Age
Home Address	Street
	City, State, Zip
Home Telephone
Business Address & Telephone
Telephone number at which legal guardian or parent may be reached in case of emergency
Email address
Height of Student
Student Weight
State any health and/ or food problems/ allergies		Vegetarian
		no yes
Date of last Tetanus shot
Who recommended Equisports Unlimited to you?
Child have previous riding experience?	no yes
Experience YES? select all applicable	hold down shift or ctrl to multiple select
Please Outline riding expereince (lessons, shows, etc.)
Please select your desired week(s) starting


MEDICAL RELEASE
In an emergency, if parent or legal guardian cannot be reached, may one of the Equisports Unlimited Summer Camp Staff take student to a doctor of our choice?	YES NO
	YES, I hereby give permission to the physician selected by Equisports Unlimited to secure proper treatment for, and hospitalize if necessary, the child listed. Every effort will be made to contact the parent or guardian should such an emergency arise.
Do you give consent to medical treatment, in an Emergency, in the event that you cannot be reached?	YES NO
	YES, ALL SUCH EXPENSES WILL BE THE RESPONSIBILITY OF AND SHALL BE PAID FOR BY THE PARENT(S) OR LEGAL GUARDIAN
Mandatory Medical Insurance company
Medical Insurance Policy Number
Medical Insurance Phone Numbers
Medical Insurance Agent (if known)
Medical Insurance Co. Address	Street
	City, State, Zip
Family Doctor
Family Doctor Phone Number
May student participate in all activities on property of Equisports Unlimited Riding Camp	Yes No
Will student be bringing his/ her own horse?	Yes No Facilities are limited
	Reservations must be made in advance
Please Note: A Vet certificate stating that all shots are current - must be supplied before session starts
RELEASE AND HOLD HARMLESS AGREEMENT	I acknowledge the risks involved in riding and working around horses, which include bodily injury from using, riding, training or being in close proximity to horses. In addition, it is my clear understanding that both horse and rider can be injured in normal daily activities as well as during showing and competition. We hereby agree to hold harmless and indemnify EQUISPORTS UNLIMITED owner, Annett Demma and further release them from any liability or responsibility for accident, damage, injury, or illness to the Undersigned or any horse owned by the Undersigned or to any family member or spectator accompanying the Undersigned on the premises of EQUISPORTS UNLIMITED.
must read
I have read and agree	(must type "yes")
A minimum $25 deposit must be received to reserve your desired spot. Also include copy of medical insurance card with your check.

Be sure all fields are properly answered and filled in or Form will automatically RESET

Children will be provided Mid-morning Snack and camp T-shirt
Clothing: Long pants, closed toed shoes, sun block. No baggy clothes.
If Child has own saddle, helmet, gloves, etc; they are to bring them. If not, they will be provided.
For those who bring their own horse, there will be a stall fee of $20/day ($100/week), limited space available - please call for reservation. Horses must have updated shots/ vet cert.
We reserve the right to refuse service to any child who does not follow the rules and regulations of the camp.

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