Winter 'Own-A-Horse' Camp Registration
Email address *
First & Last Name *
Your answer
Birthdate *
MM
/
DD
/
YYYY
Parents/Guardian Name(s) *
Your answer
Cell Phone *
Your answer
Home Phone
Your answer
Home Address *
Your answer
How did you hear about Legacy Stables?
Your answer
Emergency & Medical Info
Emergency Contact Name (if same as above, type 'N/A') *
Your answer
Relationship to Student *
Your answer
Emergency Contact Phone(s) *
Your answer
Preferred Hospital *
Your answer
Allergies *
Your answer
Current Medications *
Your answer
Medical Conditions (if applicable) *
Your answer
Emergency Medical Treatment Consent
In the event that medical aid is required due to illness or injury while participating in activities at Karin's Horse Connection & Legacy Stables, I give my permission and consent for medical treatment. *
Required
Photo Release
I give my permission to Legacy Stables/Karin's Horse Connection to use my and/or my child's photo and/or videotaping and/or artwork for use in general information, promotional materials, Youtube, Facebook and any other marketing activities. *
Session Registration
Preferred Dates (minimum of 3 participants per session. We reserve the right to combine sessions if minimum is not met). *
Required
Costs & Payment
$50 per session, per day
$100 for both sessions, per day
$240 for one session, for 5 days
$480 for both sessions, for 5 days

*$50 deposit due at time of registration. Balance is due the first day of camp; we can accept exact cash, check, or card.*
Please select a payment option: *
Notes
Your answer
Release of Liability
A Release of Liability form will need to be filled out at the stable on the first day of camp. If someone other than a parent or guardian is bringing your child, you can download the form off the 'Own-A-Horse' Camp page on our website and fill it out ahead of time.
What to bring/wear:
-Long Pants and Close-toed shoes
-Dress for the weather - LOTS of layers and snow gear
-Bring a snack and water bottle
-If staying all day for both sessions, bring a sack lunch
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms