Summer Day Camp 2017 Registration

North Atlanta Equestrian.

Rider Name: ______Birth date: ______Gender ____ Grade: ______

Parent Names: ______

Address:______City/State/Zip: ______

Home phone: ______Cell phone: ______Work phone: ______

Parent e-mail: ______Rider e-mail: ______

Emergency contact (other than parent): ______Relationship to rider: ______

Home phone: ______Cell phone: ______Work phone: ______

T-Shirt Size (please circle): YS YM YL AS AM AL

*Camp fee of $275 includes one riding lesson and one barn lesson each day, chores, games crafts and more. **Option 1: Pay in full before May 1st , 2017 and only pay $250.00 per child. This is a $25.00 discount. I will need completed documents and a check for $250.00 to secure a spot for your child at this rate.** **Option 2: Pay $100.00 non-refundable deposit to secure a session for your child at the regular rate of $275.00. Balance of $175.00 is due upon the first day of camp by 8:30 am.** **Option 3: Pay $300.00 the first day of camp if any spots are available. chances on this option. :-) I cannot hold spots, they are on a first come, first served basis. When I receive the payment and documents your spot is secured. Thank-you. :-)

*Each session will run 9:30a.m.-2:30 p.m. Monday through Friday, with before and after hours care available for an additional fee of $5 per child per hour.

* Sessions are limited to 10 riders. Riders should bring their own lunch, snack and water bottle.

* Please Note: For the safety of both rider and horse, there is a 250 pound weight limit for individuals wishing to participate in horseback riding activities.

Choose your session(s): Regular Camp _____ May 29th- June 3rd $275 Regular Camp _____ June 12th - 16th $275

Regular Camp _____ June 26th - 30th $275 Regular Camp _____ July 10th - 14th $275

Eventing Camp _____July 17th – 22nd $TBA Regular Camp July 24th - 28th $27

Rider Experience

Does your child have any riding experience? If so, please explain

______

I give permission for my child to attend camp and participate in all activities.

Please list any allergies you child has ______

Signed: ______Date ______

Camp is held at North Atlanta Equestrian 118 Old Mill Farm, Cartersville GA

Please mail checks to Elizabeth Southard 51 Picketts Lake Way E. Acworth, Ga 30101

(770-833-4152) [email protected], or drop them by the farm.