Summer Camp Registration Form 2019

Summer Camp Registration 2019

Complete the form below to sign up for Giddy Up and Go Riding Camps .
Camper's Name*

First NameLast Name
Age*
Sex
E-mail*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone:

Area CodePhone Number
Cell Phone:*

Area CodePhone Number
Emergency Contact:*
Emergency Phone Number:*

Area CodePhone Number
Relationship:*
(ex., parent, guardian, spouse)
Medical Condition(s):*
Rider Level*

Former CamperBeginnerLesson Program RiderOther
Date of Camp (1st Choice)*

Week 1: July 1-5 (Regular Camp $350)Week 2: July 8-12 (Variety Camp $350)Week 3: July 15-19 (Regular Camp $350)Week 4: July 22-26 AM (Tykes Camp $220)Week 4: July 22-26 PM (Tykes Camp $220)Week 5: July 29-Aug 2 (Regular Camp $350)Week 6: Aug 6-9 (Regular Camp $275)Week 7: Aug 12-15 (Evening Camp $195)
Date of Camp (2nd Choice)*

Week 1: July 1-5 (Regular Camp $350)Week 2: July 8-12 (Variety Camp $350)Week 3: July 15-19 (Regular Camp $350)Week 4: July 22-26 AM (Tykes Camp $220)Week 4: July 22-26 PM (Tykes Camp $220)Week 5: July 29-Aug 2 (Regular Camp $350)Week 6: Aug 6-9 (Regular Camp $275)Week 7: Aug 12-15 (Evening Camp $195)
Registration Details
I have read, understood, and accepted the details for registration.
- Registration forms can be submitted anytime and spots will be filled on a “first come, first served” basis.

- Before camp starts we require a completed mandatory HEP waiver which can be found on our website or are available in the Club House

- The HEP wavier can be mailed or dropped off in the mailbox labeled “Summer Camps” in the Club House.

- A cheque—written to SSMHPC– or E-transfer to ssmhpc@gmail.com must be made to secure a spot.

- Cheques for the July and August camp sessions can be post dated to June 1st, 2019

- Cancellations 30 days prior to the first day of camp will receive a re- fund. You will be charged a $50 admin fee.
Photo and Video Consent

By clicking the checkbox below you are consenting to the taking of photographs and/or video recordings of the above mentioned camper by SSMHPC. You are assigning to SSMHPC, and waiving any rights you have related to, any such photographs and/or video recordings, in whole or part, by SSMHPC.
I have read and understand the Photo and Video Consent.
Once you submit your application, and we receive payment, we will contact you to confirm the summer camp date(s) reserved for your camper.

Thank you!
Signature of Parent/Guardian or Adult Rider*

Clear
Should be Empty:

Summer Camp Registration 2019

Registration Details

Photo and Video Consent