Big Horse Therapy and Learning Center 2015 Camp Registration Form
Contact Information
Name of Parent(s):
Name of Participant:
Age:
Phone:
Email:
Address:
First Choice Camp(s):
Second Choice Camp(s):
Friends/sibs attending:
Payment Amt/Method:
Camp 1A – June 1 – 5 – Half-Day Camp “Lil Buckaroos,” ages 4-8 years, $300 (9 am -12:30 pm M-F)
Camp 1B – June 1 – 5 – Half-Day Camp “Horse Whisperer,” ages 11-adult, $200/$100 for volunteers (1-5 pm M-F)
Camp 2 – June 15 – 19 – Leadership Camp and Advanced & Hunter Jumper Camp, $425 (9-4 M-F)
Camp 3 – June 29 – July 3 – Cari’s Horse Lovers’ Camp, ages 5 and up, $425 (9-4 M-F) – please inquire if space
Camp 4 – July 13 – 17 – Standard Horse Lovers’ Camp, ages 5-12, $425 (9-4 M-F) - FULL
Camp 5 – July 27 – 31 – Horse Buddy Leadership Camp, ages 5 and up, $425/$395 (9-4 M-F)
Camp 6 – August 10 – 14 – Horse Buddy Leadership Camp, ages 5 and up, $425/$395 (9-4 M-F)
*Age ranges are provided as a guideline and exceptions may be made. For instance, siblings may choose to
attend camp together.
Please describe any riding experience:
Please share any helpful information relating to your child’s personality or learning style and what (s)he looks
forward to at camp:
Describe any health concerns, special needs, or allergies here:
Deposit of $225 due at time of registration payable to Good Reception Ranch (G.R.R.). Please make payment at ranch,
send check to P.O. Box 11395, Denver, CO 80211, or send bank transfer to JP Morgan Chase, Routing No. 102001017, Acct
No. 958911000.
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This summer Big Horse Therapy and Learning Center at Good Reception Ranch is offering
six weeklong camps geared toward different abilities and interests.
Choose from 6 Camps:
1. Camp 1 A: June 1 – 5 - Half-Day Camp (9 am - 12:30 pm) for kids 4-8 ($300). This is a great,
safe way to introduce young cowboys and girls to the riding life. With assistance, young campers
learn to work safely around horses. Each day involves one group riding lesson as well as activities
on the ground to learn the basics of horse behavior and care. Each participant is matched with a
suitable horse and is able to learn at his or her own speed.
1. Camp 1 B: June 1 – 5 - Half-Day Horse Whisperer Camp (1 - 5 pm) Experienced "hands"
(ages 11 - adult) are welcome to volunteer in the morning and to join us in the afternoon for our
Horse Whisperer camp, focusing on leadership, connection, and communication through activities
like round penning, groundwork, massage, energy work, and animal communication (little or no
riding is involved). $200 for non-volunteers; $100 for those volunteering with us this summer.
$40/day drop in. We encourage anyone wanting to improve their horse handling skills to join us for
this innovative camp.
2. Camp 2 A: June 15 – 19 – Advanced / Hunter Jumper Camp (9-4 M-F, $425) – This camp is
for those who can ride independently at the walk and trot (canter optional). With Liz and extra help
from other GRR instructors, campers will learn what it takes to prepare for a horse show. Even
those less interested in horse showing will still learn valuable lessons about how to handle horses
confidently in a challenging, new environment such as a show. Activities will include mane and tail
braiding, horse bathing, and course design. If experience allows, riders may opt for jumping
lessons with resident trainers Cj Wagoner or Ali Graves Kish (lessons up to twice a day!) and/or a
weekend schooling show held at the ranch (additional fees would apply for second daily lesson
and/or horse show).
2. Camp 2 B: June 15 – 19 – Leadership Camp (9-4 M-F, $425) — This camp is for participants
11 and up who love horses and want to learn how to be a respectful, effective leader for humans
and horses. Based upon experience and preference, participants will have the choice to ride with
Liz or another GRR instructor for their daily riding lessons. This is a great camp for anyone wanting
to volunteer with us throughout the summer.
3. Camp 3 – June 29 – July 3 - Cari's Horse Lovers’ Camp (9-4 M-F, $425)
4. Camp 4 – July 13 – 17 - Standard Horse Lovers' Camp (9-4 M-F, $425) –v Our basic camp for
horse lovers, this is a great introductory camp for those new to riding or new to our ranch.
Returning campers can always learn—and share—a lot!
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5 riding lessons plus a range of afternoon activities, including bareback riding, ground work
with horses, herd observation, and more.
Emphasis on equine feeding, first aid, fun barn chores, and knowledge of horse parts, colors,
and breeds.
Fun, casual horse show—a demonstration of what the campers have learned—from 3-4
Friday afternoon.
5. Camp 5 – July 27 – 31 (9-4 M-F, $425/$395) – Horse Buddy Leadership Camp – This camp is
like our Standard Horse Lovers' Camp but we have two tracks—one, (5A), for younger campers
who may need a little support catching, grooming and tacking their horses. And a second track
(5B) for those who are able to independently catch, groom, and tack their horse. Those in the
second track receive a $50 discount and commit to helping the younger campers during their
lessons, which, as always, are taught by our PATH-certified instructor. Through this pairing of
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younger and older participants, campers are able to practice ways of being confident, kind leaders.
Open to all but perfect for siblings or friends of different ages.
6. Camp 6 - August 10 - 14 – Horse Buddy Leadership Camp (9-4 M-F, $425/$395)
LEADERSHIP PROGRAM – Weekly commitment; pick your availability, all camps except for Camp 2.
Individuals 11 and up can apply to help with our summer camps. Participants will have many opportunities to
learn and practice horse handling and even trainings skills, and they will gain confidence in their ability to
inspire peers and younger participants. Please inquire for more details.
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What people love about our camps:
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Our horses are well trained and well-cared for and our riders learn real riding and horsemanship skills.
We offer small groups with lots of personal attention from our instructors and lots of hands on time
with horses; camps are capped at 10 participants and our instructor to student ratio is 1:5 or better.
Instruction comes only from our trained and experienced staff, but we have a group of dedicated
volunteers who assist our younger campers and who help make the week fun. The exchange between
participants of different ages is something the kids love.
We create an atmosphere that provides a good mix of support and challenge for riders of different
abilities; teaching is targeted to the individual needs of each student.
With help from our instructors, campers are able to choose the horses they will partner with for the
week.
Campers ride one to two times per day, including an afternoon session of bareback riding.
Opportunities to work with horses on the ground and at liberty and to learn special skills like equine
massage.
Participants improve observation skills, practice setting boundaries and intentions, and learn to regulate
energy levels to influence the horse.
Campers are supported in learning how to be respectful toward all participants human and equine.
Lead Facilitator:
Liz Polanco is a certified therapeutic riding instructor offering summer camps and year round lessons at Good
Reception Ranch. Liz developed a passion for horses and camps as an award-winning volunteer at CTRC summer
camps from 2005-2008. She has a deep well of patience and understanding for her horse and human students,
and she has the stamina and humor to keep up with the wildest of summer campers! For more information
about us, including our herd, please visit www.BigHorseTLC.com. Check out our Facebook page for pictures from
past camps.
More Camp Details:
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Activities take place in the barn and indoor and outdoor arenas so campers should be prepared for the
elements.
Campers should bring lunch, snacks, drinks, sunscreen, and hats.
Helmets available for use or participants can bring their own ASTM/SEI certified helmets. Closedtoe shoes and long pants are required for riding and working with horses. When possible smooth-soled
boots with heels are encouraged. We do have a gear recycling box at the ranch (feel free to donate or to
check it out).
Horse show at the close of camp (3 – 4 pm Friday) to showcase what campers have learned.
Those new to the ranch are requested to do at least one lesson before the start of camp ($55 for intro
to ranch, horse selection, and riding lesson; $45 for semi-private if attending with friend or sibling).
Big Horse Therapy and Learning Center Summer Camp Checklist
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Camp Registration Form
Consent for Emergency Medical Treatment Form
Photo Release Form
Payment
First time campers, please schedule an intro lesson in April or May
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Payment Information:
 A deposit of $225 reserves a spot in one camp and early bird pricing. Full payment for all camps is
due on June 1, 2015.
 Please inquire if you need to set up an online payment plan.
 Refunds will be given up to one month in advance or later if your spot can be filled.
 Deposit of $225 due at time of registration payable to Good Reception Ranch (G.R.R.). Please leave payment
in the black box at the ranch, send check to P.O. Box 11395, Denver, CO 80211, or send a bank transfer to JP
Morgan Chase, Routing No. 102001017, Acct No. 958911000. Fax (303) 293-8441
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I will email you with confirmation and a receipt.
Location and Directions:
Camps are held at Good Reception Ranch, a working horse farm, training facility and breeding operation with
show horses that compete in a number of English and Western events. Many of our wonderful therapeutic
horses are actively showing or retired from distinguished careers. We also draw from the wealth of experience
of other trainers and instructors at Good Reception Ranch (GRR). We enjoy a range of indoor and outdoor
facilities at GRR.
Good Reception Ranch at 2700 County Road 10, Erie is 25 minutes from downtown Boulder/Denver/Longmont.
From Boulder:
Take 119/The Diagonal Highway to Highway 52/Mineral Rd.
Head east on Highway 52/Mineral Rd. 9.2 miles to Weld County Road 5 (You will drive 4.5 miles past Hwy 287)
Turn right on CR 5 and head south for 2 miles to CR 10. (If you reach Erie High School you have gone too far.)
Turn left on CR 10 and head east .7 miles to Good Reception Ranch - 2700 CR 10 - on right.
(If you reach CR 7 you have gone too far.)
Look for red and white sign in front of a row of juniper bushes; our large white barn with red roof is set back off of road.
Parking and main entrance on north side of barn.
From Highway 287 (Take Baseline, Arapahoe, or Valmont to reach 287):
From 287, head east on Isabelle Road (to the west this jogs to become Valmont, to the east this is Erie Parkway) 3.7 miles to CR 5 (you
will see Erie High School on the corner).
Turn left on CR 5 and head north 1 mile to first right, CR 10.
Turn right on CR 10 and head east .7 miles to Good Reception Ranch - 2700 CR 10 - on right. (If you reach CR 7 you have gone too far.)
Look for red and white sign in front of a row of juniper bushes; our large white barn with red roof is set back off of road.
From Denver/I-25:
Head north on I-25 to Exit 232, Erie/Dacono.
After exiting highway, turn left and head west 1 mile on Erie Parkway to CR 7.
Turn right on CR 7 and head north 3/4 mile to first road on left , a private half half-road marked by a white vinyl fence and mailboxes.
Turn left on dirt road and head west .3 miles to Good Reception Ranch – 2700 CR 10 - on right. You can't miss the large barn with red
roof.
If you miss the half-road or if the gate is closed, proceed on CR 7 1/4 mile to CR 10 and turn left; a second ranch entrance will be on
your left after the row of juniper bushes.
Big Horse Therapy and Learning Center at Good Reception Ranch, LLC
Physical Address: 2700 CR 10, Erie, Colorado
(303) 478-0768
GoodReceptionRanch@gmail.com
www.BigHorseTLC.com
www.GoodReceptionRanch.com
Mailing address: Good Reception Ranch, P.O. Box 11395, Denver, CO 80211
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Fax: 303-293-8441
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Consent & Release Form: Consent for Emergency Medical Treatment
In the event emergency medical aid/treatment is required due to illness or injury while participating in the
services of Big Horse Therapy and Learning Center, I authorize staff to secure and retain medical treatment
and/or transportation if needed. This authorization includes any treatment deemed necessary by a treating
health care professional and includes but is not limited to x-ray, surgery, hospitalization, and medication. In
addition, I authorize Big Horse TLC to release me/my child/my ward’s record to any individual involved in
medical treatment and/or necessary transportation.
Name ________________________________________________________________________________
In Case of emergency, contact ___________________________________ Phone ___________________
or contact ___________________________________________________ Phone___________________
Date ___________________ Participant Signature ____________________________________________
Date ___________________ Guardian Signature (if <18) _______________________________________
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Release of Liability
GOOD RECEPTION RANCH, LLC
Under Colorado Law, an equine professional is not liable for the injury to or the death of a participant in equine activities
resulting from the inherent risks of equine activities, pursuant to section 13-21-119, Colorado Revised Statutes.
This RELEASE of LIABILITY is made and entered into between Good Reception Ranch LLC hereinafter designated GRR and
________________________________________________________ hereinafter designated RIDER, and if Rider is a minor,
Rider’s parent or guardian, _____________________________________________ on ___________________, 2015 (date).
In return for the use, today and on all future dates of the facilities, horses and services of GRR, the Rider, his heirs, assigns,
and legal representatives, hereby expressly agree to the following:
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It is the responsibility of the Rider to carry full and complete insurance coverage on his personal property and
himself.
Rider agrees to assume ANY AND ALL RISKS INVOLVED IN OR ARISING FROM THE RIDER’S USE OF OR PRESENCE
UPON GRR’s FACILITIES including, without limitation but not limited to, the risks of death, bodily injury, property
damage, falls, kicks, bites, collisions with vehicles, horses or stationary objects, fire or explosion, the unavailability
of emergency medical care, or the negligence or deliberate act of another person.
Rider agrees to hold GRR and 2700 Weld County Road LLC hereinafter designated 2700 and all of its successors,
assigns, subsidiaries, affiliates, officers, directors, employees, instructors, and agents completely harmless and not
liable and release them from all liability whatsoever and AGREES NOT TO SUE them on account of or in connection
with any claims, causes of action, injuries, damages, cost or expenses arising out of Rider’s use of or presence upon
GRR’s property and facilities, including without limitation, those based on death, bodily injury, property damage,
including consequential damages, except if the damages are caused by the direct, willful and wanton negligence of
the Instructor. This document includes but is not limited to Trainers / Instructors Tom Forehand, Alison Kish,
Michelle (Mica) Graves, Liz Polanco, Cj Wagoner, and Jeff Burley.
Rider agrees to waive the protection afforded by any statute or law in any jurisdiction whose purpose, substance
and/or effect is to provide that a general release shall not extend to claims, material or otherwise, which the
person giving the release does not know or suspect to exist at the time of executing the release.
Rider agrees to indemnify and defend GRR and 2700 against, and hold it harmless from, any and all claims, causes
of action, damages, judgments, costs or expenses, including attorney’s fees, which in any way arise from the
Rider’s use of or presence upon GRR’s property and facilities.
Rider agrees to abide by all of GRR’s rules and regulations.
This contract is non-assignable and non-transferable and is made and entered into the State of Colorado, and shall
be enforced and interpreted under the laws of this state. Should any clause be in conflict with State Law, then that
clause is null and void.
When the Rider and Rider’s parent or guardian, if Rider is a minor, sign this contract, it will then be binding on both parties,
subject to the above terms and conditions.
_______________________________________________
Rider’s Signature
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AND Parent’s Signature if Child is a Minor
_______________________________________________
Rider’s Telephone Number
_______________________________________________
Emergency Contact Name
_______________________________________________
Date of Birth if Rider is a Minor
_______________________________________________
Emergency Contact Number
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Big Horse Therapy and Learning Center Photo Release
Mica Graves and Big Horse Therapy and Learning Center at Good Reception Ranch use photographs
taken during summer camps and lessons for several reasons: one, to use for learning purposes, two, to
serve as camp mementos, and three, to help tell the story of how healing the horse-human connection
can be.
If there is interest, camp pictures can also be shared through our Facebook page. This is an easy way
for parents to access and download photos from camp. We provide a special link so that you don’t
need an account to access the camp album. First names are seldom used, and last names are never
used unless participants choose to identify themselves on online media.
Please mark one or more of the following boxes:
o I agree to allow photos of me, other visiting family members, and/or my child to be used to
help other parents and future participants better understand Big Horse TLC’s programs. If a
photo is selected for use, it would appear primarily on our website and/or flyers sent to our
email list. Occasionally a printed flyer is used for small local events (i.e., when we participate
in a benefit or silent auction fundraiser).
o Personal or group photos of participants will be used only for journaling, awards, weekly
emails to parents, etc.
o Please ask me before using any photo for use that is more than personal.
o Special instructions:
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
Parent/Guardian Name: _________________________________________________________________
Child(ren)’s Name(s): ___________________________________________________________________
Signature: ______________________________________________ Date: _________________________
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