Lone Star Ranch Horse Camp Registration
We are excited to have your child join us for camp! Please complete and submit this registration form for each individual so that we may start the registration process.

Please note that registration is not complete and your child's spot cannot be held without completed payment.
Thank you!
Email address *
Camper Full Name *
Your answer
Email for Primary Guardian or Adult Registering Child *
Your answer
Home Phone *
Your answer
How did you hear about us? *
We're a family owned business, so letting us know how you heard about us helps us to better understand our referral sources and acknowledge those that value us! Thank you for your response.
If "Other," please let us know how/where:
2020 Spring - Spring Week Camp Requested
8:30am-1pm
2020 Spring Weekend Camp
11:00am-2:00pm
2020 Summer Camp Sessions Requested
Family Information *
Address (Street, City, State)
Your answer
Mother's Name, Cell Phone Number, Email Address
Your answer
Father's Name, Cell Phone Number, Email Address
Your answer
Participant's Personal Information
This personal information will help us to match each camper with the best horse for them!
Child's Height (ft, in.) *
Your answer
Child's Weight (lbs) *
Your answer
Age *
Your answer
Gender *
Birthday (ex: 01/01/2001) *
Your answer
Grade *
School
Your answer
PARTICIPANT HEALTH and SAFETY QUESTIONNAIRE
EMERGENCY CONTACT (Name & Relationship) * *
Your answer
EMERGENCY CONTACT PHONE * *
Your answer
Medical Insurance Company / Phone * *
Your answer
Policy Number / Group # * *
Your answer
Does your child have any health issues that would prevent you from participating safely today OR that we need to be aware of? (i.e. heart problems, seizures, asthma, diabetic, etc.) *
Does your child have any physical limitations or disabilities that would affect participation today OR that we need to be aware of? *
Does your child have any severe allergies of which we need to be aware? (i.e. insects/bees, sun, plants, etc.) *
Is your child currently taking any medications? *
Do your child have any history of mental health issues? *
If you selected YES to any of the above medical questions, please define:
Your answer
Experience/Skill Level
Riding Ability *
Skills - Please select all that apply
Please list/describe all riding experience
Your answer
Acceptance of Terms & Payment Information
I have disclosed all physical and mental health issues. All the information provided is accurate and complete. * *
Required
I understand that registration is not complete until payment is received by Lone Star Ranch * *
Required
By initialing this form, you verify that the information provided is true and complete, that you are a responsible party for the camper, over the age of 18yrs. * *
Your answer
Payment Information
Camp Registration is not complete until payment is received. Please complete the credit card information below. If you would prefer, you may call our office to discuss payment by check. All payment information is kept confidential.
Card Type *
Name on Card *
Your answer
Card / Gift Certificate # *
Your answer
Expiration Date *
Your answer
Card Billing Address (Street, City, State, Zip) *
Your answer
SCC Code on the back of the card *
Your answer
I am the individual authorized to use this card. By providing this information, I give Lone Star Ranch or its partners (Texas Trail Rides or The Texas Horse Center) permission to use it to process payment for this horse camp. *
Submit
Never submit passwords through Google Forms.
This form was created inside of Lone Star Ranch, Texas Trail Rides & The Texas Horse Center. Report Abuse