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Summer Horse Camp 2024
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* Indicates required question
Choose. Camp
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Horse Camp (Riding)
Inspiration Camp (Creating)
Session Dates: Select all that you are attending
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Session 1: June 10-14
Session 2: June 17-21
Session 3: June 24-28
Session 4: July 1-5
Session 5: July 8-12
Session 6: July 15-19
Session 7: July 22-26
Session 8: July 29- August 2
Session 9 August 5-9
Session 10 August 12-16
Required
CAMPER INFORMATION
Camper's first name
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Your answer
Camper's last name
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Your answer
Parent/Guardian First and Last Name
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Your answer
Parent/Guardian Phone (best contact #)
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Your answer
Home address
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Your answer
Camper's Date of Birth
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MM
/
DD
/
YYYY
Camper Height
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Your answer
Age (campers must be at least 5 years of age at the start of camp)
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Your answer
Camper Weight
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Your answer
Does camper have any allergies?
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YES
NO
If yes, please explain/ list (peanuts, bee stings, dust, medications, etc.)
Signed consent form is mandatory if medication is required
Your answer
Does camper have any health or behavioral challenges we should be aware of?
*
YES
NO
If yes, please describe any health or behavioral challenges:
Signed consent form is mandatory if medication is required
Your answer
SHEC provides pizza to campers on Fridays for lunch. Please let us know if you do not wish for your camper to eat pizza. The pizza may contain allergens.
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Yes, this camper can eat pizza.
No, please do not offer pizza to this camper.
Is Camper attending camp with sibling(s)?
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Yes
No
If yes, please list names of sibling(s):
Your answer
How many times has camper ridden a horse?
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0
1-10
10-19
20+ times
Please answer whether or not your camper has done the following:
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Yes
No
been on a trail ride
been to horse camp
done a pony ride
taken riding lessons
ridden English
ridden Western
ridden bareback
trotted a horse
cantered a horse
jumped a horse (we do not jump at camp)
Yes
No
been on a trail ride
been to horse camp
done a pony ride
taken riding lessons
ridden English
ridden Western
ridden bareback
trotted a horse
cantered a horse
jumped a horse (we do not jump at camp)
Please share any additional information we should know about your camper here:
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Your answer
INSURANCE INFORMATION
Insurance Company
*
Your answer
Insurance Policy #
*
Your answer
Insurance Contact Name
*
Your answer
Insurance Phone #
*
Your answer
WHO IS AUTHORIZED TO PICK UP YOUR CAMPER FROM CAMP
#1 Full Name
*
Your answer
#1 Phone
*
Your answer
#2 Full Name
*
Your answer
#2 Phone
*
Your answer
#3 Full Name
*
Your answer
#3 Phone
*
Your answer
IN CASE OF EMERGENCY, PLEASE CONTACT:
Emergency Contact #1 Full First and Last Name
*
Your answer
Emergency Contact #1 Phone
*
Your answer
Emergency Contact #1 Relation to Camper
*
Your answer
Emergency Contact #2 Full First and Last Name
*
Your answer
Emergency Contact #2 Phone
*
Your answer
Emergency Contact #2 Relation to Camper
*
Your answer
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