Lakes Ranch Teen Horse Camp Registration
Welcome to bring own horse. If Hiring a horse there is a waiting list.

Email me (Sarah) if any queries: horsecamp@lakesranch.org.nz

Deposit of $150 to be paid on completion of this form. Balance to be paid by 23th September please.
First Name *
Last Name *
Gender *
Which camp will this camper be attending? *
Registration $365 (includes horse hire) or $290 (excludes horse hire)
Date of Birth *
MM
/
DD
/
YYYY
Age *
Will your child hire a Lakes Ranch horse or bring their own? *
Required
Riding Ability *
Which horses has your child ridden previously?
(complete only if your child has attended a Lakes Ranch horse camp previously, with the use of a Lakes Ranch horse)
Does your child have any friends attending camp that they would like to be in a cabin with?
Please note we cannot confirm that your child will be grouped with these campers
Street Number *
Street Name *
Suburb *
Town/City *
Postcode *
Parent/Guardian *
Name
Parent/Guardian *
Email Address
Home Phone *
Please include area code
Work Phone *
If applicable
Mobile Phone *
Emergency Contact Name *
Please provide details for a person we can contact should we not be able to contact you in the event of an emergency. We will require the contact's name, phone number, mobile number (if available) and their relationship to the child.
Emergency Contact *
Home Phone Number- Please include area code
Emergency Contact *
Mobile Phone
Please note any allergies your child has
ie. Food, Animal or plant allergies
Please note any medical conditions your child has
ie. Asthma, diabetes
Please note any disabilities or behavioral conditions that may require special care
Do you give permission for Lakes Ranch to administer paracetamol, panadol or ibuprofen? *
Lakes Ranch may provide these medications if necessary for the comfort of your child
Please specify any medication your child will need to take during camp
Note: all medication including panadol and antihistamines will need to be handed in
Does your child have any other needs we should be aware of?
Please specify
Is there anyone who is not allowed access to your child?
If yes, please provide names in the space provided.
Does your child receive support from any of the following agencies?
If yes, please select as many as are relevant.
Who will be picking up your child from camp? *
If this is to change you must notify the camp before camp finishes
Do you consent to your child being sent follow-up information and studies by Lakes Ranch? *
Payment Details *
Please make sure all relevant information is enclosed above. The attendees camp fees will be paid online please use the reference "THC" for camper "Surname" and "Month of Camp". A non-refundable $150 deposit is required on registering. Eftpos is not available. Refer to email as to date full fees are due.
Declaration by Parent/Caregiver (signature will be required at sign-in) *
1. I consent to all the information supplied in this form being used for the purpose of running the camps and agree that my child will abide by camp rules. 2. In the event of sickness or accident I authorise that qualified medical attention be secured and notification followed by any expenses sent to me at the above address. 3. I agree that staff and leaders will be clear of all liability in the event of any injury or loss which the camper may sustain to person or property. I also agree to pay for any damage incurred by my child to any Lakes Ranch property, by either accident or malicious intent. 4. I consent to photos and video being taken at camp for promotional and advertising purposes. 5. I acknowledge that the $150 deposit is non refundable. See due by date for balance on acceptance email.
Required
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