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3700 Holland Ave. Cobble Hill
BC, Canada V0R 1L3
riding@alpinestable.com

Summer Camp Application Form

What do you learn?

Our camps are filled with many different activities. During their week campers will learn safety and horsemanship skills such as grooming, horse care and preparation, groundwork/handling, stable management. Horse care topics such as horse anatomy, hoof care, tack cleaning, feeding, paddock cleaning, braiding and of course riding!

How much does camp cost?

Day camp is $650 for Monday-Thursday 9-4 Friday 9-12

What should you bring?

Please bring lunch and snacks, water bottle, hat, boots with a heel, comfortable pants for riding, helmet (we have limited numbers available on site), weather appropriate clothes bring layers as weather can be unpredictable, bathing suit for water games.

Must have pants and boots to be able to ride!

NO SANDALS

Covid 19 Considerations

Proof of vaccination will be required to protect staff and campers. We are taking all necessary precautions to ensure the safety of our campers, instructors and barn community.  Campers will be assigned groups which they will remain in for the week long camp. Hand washing and sanitizing stations are readily available, and campers are required to wash their hands after each activity. All surfaces will be sanitized after each activity. During check in each morning campers will be required to wash their hands and parents will be required to fill out a Covid waiver declaring that neither the camper or household have symptoms or had exposure to anyone who may be infected. Face coverings will be required when physical distancing is not possible.  In order to protect everyone at our camps we request that participants do not travel off island the two weeks prior to camp.  If you have travelled please let us know.  We appreciated everyone’s understanding and thank you for helping is continue to run a safe and enjoyable camp!

If the camps are cancelled due to Covid deposits will be fully refunded

Have more questions?

Please email/text Carla at riding@alpinestable.com 250-812-6115

Please arrive 10-15 minutes early on the first day to complete registration.

Today's Date: December 7, 2022

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information
Please check which camp(s) you wish to attend
MARCH 21-25 FULL DAY $650
MARCH 21-25 HALF DAY $400
JULY 4-8 DAY $650.00 includes gst
JULY 18-22 DAY $650.00 includes gst
AUG 1-5 DAY $650.00 includes gst
AUG 15-19 DAY $650.00 includes gst

PLEASE LIST ANY MEDICAL CONDITIONS INCLUDING ALLERGIES/LEARNING DISABILITIES/ MEDICAL ISSUES THAT WE SHOULD KNOW ABOUT
RIDING EXPERIENCE: choose lower level if unsure*
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Information
Please check which camp(s) you wish to attend
MARCH 21-25 FULL DAY $650
MARCH 21-25 HALF DAY $400
JULY 4-8 DAY $650.00 includes gst
JULY 18-22 DAY $650.00 includes gst
AUG 1-5 DAY $650.00 includes gst
AUG 15-19 DAY $650.00 includes gst

PLEASE LIST ANY MEDICAL CONDITIONS INCLUDING ALLERGIES/LEARNING DISABILITIES/ MEDICAL ISSUES THAT WE SHOULD KNOW ABOUT
RIDING EXPERIENCE: choose lower level if unsure*
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Information
Please check which camp(s) you wish to attend
MARCH 21-25 FULL DAY $650
MARCH 21-25 HALF DAY $400
JULY 4-8 DAY $650.00 includes gst
JULY 18-22 DAY $650.00 includes gst
AUG 1-5 DAY $650.00 includes gst
AUG 15-19 DAY $650.00 includes gst

PLEASE LIST ANY MEDICAL CONDITIONS INCLUDING ALLERGIES/LEARNING DISABILITIES/ MEDICAL ISSUES THAT WE SHOULD KNOW ABOUT
RIDING EXPERIENCE: choose lower level if unsure*
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information
Please check which camp(s) you wish to attend
MARCH 21-25 FULL DAY $650
MARCH 21-25 HALF DAY $400
JULY 4-8 DAY $650.00 includes gst
JULY 18-22 DAY $650.00 includes gst
AUG 1-5 DAY $650.00 includes gst
AUG 15-19 DAY $650.00 includes gst

PLEASE LIST ANY MEDICAL CONDITIONS INCLUDING ALLERGIES/LEARNING DISABILITIES/ MEDICAL ISSUES THAT WE SHOULD KNOW ABOUT
RIDING EXPERIENCE: choose lower level if unsure*
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information
Please check which camp(s) you wish to attend
MARCH 21-25 FULL DAY $650
MARCH 21-25 HALF DAY $400
JULY 4-8 DAY $650.00 includes gst
JULY 18-22 DAY $650.00 includes gst
AUG 1-5 DAY $650.00 includes gst
AUG 15-19 DAY $650.00 includes gst

PLEASE LIST ANY MEDICAL CONDITIONS INCLUDING ALLERGIES/LEARNING DISABILITIES/ MEDICAL ISSUES THAT WE SHOULD KNOW ABOUT
RIDING EXPERIENCE: choose lower level if unsure*
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information
Please check which camp(s) you wish to attend
MARCH 21-25 FULL DAY $650
MARCH 21-25 HALF DAY $400
JULY 4-8 DAY $650.00 includes gst
JULY 18-22 DAY $650.00 includes gst
AUG 1-5 DAY $650.00 includes gst
AUG 15-19 DAY $650.00 includes gst

PLEASE LIST ANY MEDICAL CONDITIONS INCLUDING ALLERGIES/LEARNING DISABILITIES/ MEDICAL ISSUES THAT WE SHOULD KNOW ABOUT
RIDING EXPERIENCE: choose lower level if unsure*
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information
Please check which camp(s) you wish to attend
MARCH 21-25 FULL DAY $650
MARCH 21-25 HALF DAY $400
JULY 4-8 DAY $650.00 includes gst
JULY 18-22 DAY $650.00 includes gst
AUG 1-5 DAY $650.00 includes gst
AUG 15-19 DAY $650.00 includes gst

PLEASE LIST ANY MEDICAL CONDITIONS INCLUDING ALLERGIES/LEARNING DISABILITIES/ MEDICAL ISSUES THAT WE SHOULD KNOW ABOUT
RIDING EXPERIENCE: choose lower level if unsure*
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information
Please check which camp(s) you wish to attend
MARCH 21-25 FULL DAY $650
MARCH 21-25 HALF DAY $400
JULY 4-8 DAY $650.00 includes gst
JULY 18-22 DAY $650.00 includes gst
AUG 1-5 DAY $650.00 includes gst
AUG 15-19 DAY $650.00 includes gst

PLEASE LIST ANY MEDICAL CONDITIONS INCLUDING ALLERGIES/LEARNING DISABILITIES/ MEDICAL ISSUES THAT WE SHOULD KNOW ABOUT
RIDING EXPERIENCE: choose lower level if unsure*
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information
Please check which camp(s) you wish to attend
MARCH 21-25 FULL DAY $650
MARCH 21-25 HALF DAY $400
JULY 4-8 DAY $650.00 includes gst
JULY 18-22 DAY $650.00 includes gst
AUG 1-5 DAY $650.00 includes gst
AUG 15-19 DAY $650.00 includes gst

PLEASE LIST ANY MEDICAL CONDITIONS INCLUDING ALLERGIES/LEARNING DISABILITIES/ MEDICAL ISSUES THAT WE SHOULD KNOW ABOUT
RIDING EXPERIENCE: choose lower level if unsure*
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information
Please check which camp(s) you wish to attend
MARCH 21-25 FULL DAY $650
MARCH 21-25 HALF DAY $400
JULY 4-8 DAY $650.00 includes gst
JULY 18-22 DAY $650.00 includes gst
AUG 1-5 DAY $650.00 includes gst
AUG 15-19 DAY $650.00 includes gst

PLEASE LIST ANY MEDICAL CONDITIONS INCLUDING ALLERGIES/LEARNING DISABILITIES/ MEDICAL ISSUES THAT WE SHOULD KNOW ABOUT
RIDING EXPERIENCE: choose lower level if unsure*
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Secondary Emergency Contact

Name

Phone number
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information
Please check which camp(s) you wish to attend
MARCH 21-25 FULL DAY $650
MARCH 21-25 HALF DAY $400
JULY 4-8 DAY $650.00 includes gst
JULY 18-22 DAY $650.00 includes gst
AUG 1-5 DAY $650.00 includes gst
AUG 15-19 DAY $650.00 includes gst

PLEASE LIST ANY MEDICAL CONDITIONS INCLUDING ALLERGIES/LEARNING DISABILITIES/ MEDICAL ISSUES THAT WE SHOULD KNOW ABOUT
RIDING EXPERIENCE: choose lower level if unsure*
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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