MES Camp Registration Form
Fill this registration form out for any of these listed camps. Summer Camp, Winter Break Camp, Spring Break Camp, After School Camp, Off Track Camp, Holiday Camp, Teacher Work Day Camp, Early Release Day Camp.

Please fill out 1 form per Camper.

Under North Carolina law, an equine activity sponsor or equine professional is not liable for an injury to or the death of a participant in equine activities resulting exclusively from the inherent risks of equine activities. Chapter 99E of the North Carolina General Statutes.

Email address *
Student Information
Student Full Name (First and Last) *
Your answer
DOB *
Your answer
School *
Your answer
Grade
Your answer
Weight *
Your answer
Height *
Your answer
Does the student have any previous riding experience?
What are the students riding goals, both current and future?
Your answer
2019 Camp Dates
Farm Camp $250 per week / $60 day drop-in.
Horse Immersion $420 per week / $90 day drop-in
Weekly Camp Selections Only (Drop-In Selections are below)
Farm Camp $250/Week
Horse Immersion $420/Week
Eventing Camp $300 Deposit/Price TBD
Volunteer/Staff
January 21, 22 and 23 (drop-in rate applies)
March 25-29
April 1-5
June 3-7
June 10-14
June 17-21 (Immersion is FULL)
June 24-28 (Eventing Camp Only)
July 1-5
July 8-12
July 15-19
July 22-26 (Eventing Camp Only)
July 29- August 2
August 5-9
August 12-16
August 19-23
August 26-30
Farm Camp Drop-In Dates ($60 per day)
Your answer
Horse Immersion Camp Drop-In Dates ($90 per day)
Your answer
Parent/Guardian Information
Parents/Legal Guardians *
Your answer
Address *
Your answer
Best Phone for Legal Guardian 1 /Name *
Your answer
Legal Guardian 1 Email *
Your answer
Best Phone for Legal Guardian 2 /Name
Your answer
Legal Guardian 2 Email
Your answer
Person responsible for pickup up student: Name/Phone *
Your answer
Medical Information
Health History / If Yes: Please use comment box below. *
Yes
No
Visually Impared
Hearing Impared
Communication
Sensation
Heart
Breathing
Digestion
Circulation
Emotional
Behavioral
Pain
Joint/Bone
Muscular
Thinking/Cognition
Allergies
Health History Notes: Please elaborate on any Yes answers.
Your answer
Does the student have any physical limitations? If yes, please explain.
Your answer
Does the student have any allergies?
Your answer
Current Medications
Your answer
Physician Name and Phone #
Your answer
Medical Facility
Your answer
Health Insurance Company
Your answer
Emergency Situations
In the event that emergency medical aid/treatment is required due to illness or injury during the process of receiving lessons or instructions, or while being on the property of Mane Event Stables LLC, I authorize Mane Event Stables LLC to secure and retain medical treatment and transportation if needed. 2. Release participant records upon request to the authorized individual or agency involved in the medical emergency treatment. Consent: This authorization includes x-ray, surgery, hospitalization, medication and any treatment procedure deemed “life saving” by the physician. This provision will only be invoked if the person(s) above is unable to be reached.
Do you fully understand the Emergency Policy Above *
Emergency Contact Information
Emergency Contact 1 Name/Phone *
Your answer
Emergency Contact 2 Name/Phone
Your answer
Emergency Contact 3 Name/Phone
Your answer
Is there any other information we should know?
Your answer
How did you hear about Mane Event Stables? Do we need to thank anyone for the referral? *
Your answer
Payment Information
After you submit your form, you will receive an invoice via SQUARE for a 50% deposit to the camp/lesson you registered for. If you do not receive it, please check your SPAM folder.
North Carolina Ordinance
North Carolina law, an equine activity sponsor or equine professional is not liable for an injury to or the death of a participant in equine activities resulting exclusively from the inherent risks of equine activities. Chapter 99E of the North Carolina General Statutes." (c) Failure to comply with the requirements concerning warning signs and notices provided in this Article shall prevent an equine activity sponsor or equine professional from invoking the privileges of immunity provided by this Article.
Do you fully understand the North Carolina Ordinance Above? *
A copy of your responses will be emailed to the address you provided.
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