Lewisville Stables Inc 2012 Camp Registration Form
Location:
573 Lewisville Road Elkton, MD 21921
Mailing address:
P.O. Box 254, Lewisville PA 19351
Phone 302-299-3987
Please fill out separate form for each camper
Date: ___________________
Camper’s name: ________________________________ Age ________________
Address: __________________________________________________
Zip__________
Phone: _________________ cell ___________________________
e-mail: __________________________________________________
Height: ____ weight:____ age: ____ t-shirt size _________________
Parent name: _____________________________
emergency phone during camp hours:_______________________
any medications? ________________________
Riding experience: ______________________________________________
Are there any special requirements medical or behavioral? No___ Yes (describe on back)______
Is camper up on all required immunizations? Yes_____________
Week(s) in which you are enrolling_________________________________________
Before and/or after camp care?___ days:___________________________
amount: $_____________
In addition to this registration form, waiver must be signed by parent/ guardian prior to starting camp.
Camp fee: $285.00/ week $20.00 discount for second family member enrolled. $7.00/hr before/after camp care $5.00 per hour for multiple family members. There is a $50 non-refundable deposit for each week of camp you register for.
Please mail both registration form and the release form with a $50.00 nonrefundable (per camper per week) deposit to Lewisville Stables Inc. P.O. Box 254 Lewisville Pa 19351
Signature of parent/ guardian:______________________________________