2020 April Vacation Camp
April 27 - May 1
Emergency Contact Name & Number
Please list any allergies, medical needs, or other accommodations you feel we need to know about:
English or Western?
I don't know or no preference
I have never had any formal lessons but may have ridden a few times
I've taken a few lessons
I can walk and trot with the help of an instructor (leadline or lunge line)
I can walk and trot independently and know how to post the trot
I can walk and trot independently and have begun learning to canter (on the lunge)
I can walk trot and canter independantly
If attending for a partial week please check the days attending: (if nothing is checked we will assume a full week and bill accordingly)
I (DO/DO NOT) give permission for any photos of my child taken during camp to be used in Mack Hill promotional material:
I understand deposits made are NON REFUNDABLE unless 30 days notice is given
I have read and understand deposits are non refundable within 30 days of camp
I agree to the following fees, please bill me for:
Full Week: $250 deposit, $250 balance due
Second Child In Household - Full Week: $225 deposit, $225 balance due
1 Day of Camp: $62.50 deposit, $62.50 balance due
2 Days of Camp: $125 deposit, $125 balance due
3 Days of Camp: $187.50 deposit, $187.50 balance due
I understand that spots cannot be held without deposit. I will pay the following way:
I will mail a check to: 3 Mack Hill Rd Amherst, NH 03031 Attn: Camp
Please email me a credit card authorization to the email provided on this form
I agree to release for all purposes Souhegan Riders LLC, and its employees, agents, contractors and managing members (W. Scott O'Connell and Susan O’Connell), as well as the owners of 3 Mack Hill Rd., Amherst, New Hampshire (collectively, the “Equine Activity Sponsors”) from any liability related to riding, training, grooming or other equestrian activities provided by Souhegan Riders LLC. I understand, acknowledge and affirm the limitations of liability provided by New Hampshire law (See RSA 508:19) for Equine Activity Sponsors. Each participant in an equine activity expressly assumes the risk of and legal responsibility for any injury, loss or damage to person or property which results from participation in an equine activity. Each participant shall have the sole responsibility for knowing the range of his or her ability to manage, care for, and control a particular equine or perform a particular equine activity, and it shall be the duty of each participant to act within the limits of the participant's own ability, to maintain reasonable control of the particular equine at all times while participating in an equine activity, to heed all posted warnings, and to refrain from acting in a manner which may cause or contribute to the injury of any person. In signing this release, I agree that I am aware of the risks and dangers involved with horseback riding and the related equine activities. I understand that horses/ponies are large and unpredictable animals by nature, that they may bite, buck, kick, rear and otherwise act in manner which could hurt me, that even the most experienced riders may have difficulties controlling an animal, and that the resulting risks can cause serious bodily injury or even death. Being aware of these risks associated with horses/ponies, horseback riding and all equestrian activities, I consent to and assume these risks. I also agree that in addition to the limitations of liabilities provided by state law, to hold the Equine Activity Sponsors harmless for any injury or damage I suffer while engaged in an Equine Activity.
I have read Mack Hill's release and agree to be bound by it's terms
I do not agree to the terms of the release
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