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Camp

Questionnaire

By signing below, I agree that my camper will have a properly fitted, ASTM/SEI certified equestrian helmet.

  • Campers should wear riding pants and paddock boots or jeans/leggings and shoes with a small heel + fitted shirts to insure instructors can see rider position.
  • Please send a lunch with your child to enjoy between riding and crafting!
  • Campers may bring shorts to change into once they are finished riding. 

Please send in your deposit via Venmo or a check in the mail. Camp deposits are non- refundable: $100 for 4 day camps and $50 for 2 or 3 day camps.

Venmo: @Janet-Salem or @Lauren-Kissel-3 

Mail to: 153 Beavers Rd Canton, GA 30115 

You spot is only secured once both the questionnaire and deposit are received. 

First Camper's Name

First Name*

Middle Name

Last Name*
First Camper's Age Acknowledgment*
First Camper's Date of Birth*
I certify that I am 18 years of age or older
First Camper's Signature*
Second Camper's Name

First Name*

Middle Name

Last Name*
Second Camper's Date of Birth*
Third Camper's Name

First Name*

Middle Name

Last Name*
Third Camper's Date of Birth*
Fourth Camper's Name

First Name*

Middle Name

Last Name*
Fourth Camper's Date of Birth*
Fifth Camper's Name

First Name*

Middle Name

Last Name*
Fifth Camper's Date of Birth*
Sixth Camper's Name

First Name*

Middle Name

Last Name*
Sixth Camper's Date of Birth*
Seventh Camper's Name

First Name*

Middle Name

Last Name*
Seventh Camper's Date of Birth*
Eighth Camper's Name

First Name*

Middle Name

Last Name*
Eighth Camper's Date of Birth*
Ninth Camper's Name

First Name*

Middle Name

Last Name*
Ninth Camper's Date of Birth*
Tenth Camper's Name

First Name*

Middle Name

Last Name*
Tenth Camper's Date of Birth*
Parent or Guardian's Email Address

Email
Your signed waiver will be sent to the email address provided here and is available for download for three days via URL attachment.
Camper's Additional Information
Camp Week*
Previous Riding Experience*

Any Allergies

Any Medications

Please list any behavioral/learning issues. It’s important for us to know/understand if your child is ADHD/Dyslexic/Autistic/etc. Again, this form is confidential.

Parents/Emergency Contacts Info (name, phone number, relation) *
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*

Middle Name

Last Name*

Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
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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