Conner Carriages & Occasions, Inc

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Royal Horseshoe Farm: Summer Camp 2010
Royal Horseshoe Farm Inc.
601 Morgan Ford Road
Front Royal, VA 22630
(540) 636-6375
Web Site: www.royalhorseshoe.com
E-mail: [email protected]
Dear Campers / Parents / Guardians,
Welcome! We are glad that you have decided to join us for horse camp. We look forward to sharing
the joys of riding and caring for horses with you.
Here are a few things you need to know and remember:
 Bring bathing suit and towel
 Wear closed toe shoes with a small heel, preferably boots.
 Wear long pants for riding
 Bring or wear cool cotton shirts, having an extra one is a good idea
 Bring bag lunch with an extra beverage
 Sunscreen
 Bug spray
 No video games or loud toys
 No guns or weapons of any type, including water guns
 $200 registration fee is non-refundable
 Storage space is limited
Royal Horseshoe Farm Inc. will provide:
 Riding helmet-ASTM/SEI approved
 Pool with supervised swim time
 Horses and tack- please do not bring your own (unless coordinated in advance)
Each camper will have her/his own crate and will be responsible for his/her own personal property.
We will have coolers available for campers’ lunches and beverages.
Standard arrival time is between 8:45 and 9:00 a.m. at Royal Horseshoe Farm Inc. Children can be
dropped off at the recreation building at 601 Morgan Ford Road. Children must be picked up by 3:15
pm. Any other arrangements MUST be approved by Tina Anderson prior to that day.
I will be sending a tentative schedule of daily events, as well as some fun information.
Thank you! We look forward to meeting and getting to know each of you.
Sincerely,
Tina Anderson
Page 1 of 5
Royal Horseshoe Farm: Summer Camp 2010
WHAT: Royal Horseshoe Farm Summer Horse Camp
WHERE: Royal Horseshoe Farm, Front Royal, VA
WHEN: Schedule:
o
June 14th-18th
o
June 21st-25th
o
June 28th-July 2nd
o
July 12th-16th
o
July 19th-23rd
o
July 26th-30th
o
August 2rd-6th
o
August 9th-13th
o
August 16th-20th
TIME: Day Camp Monday thru Friday
Drop off campers between 8:45 and 9:00 a.m., and pick up by 3:15 pm
COST:
$250.00 per 1 week session
AGES:
Typically 8-15, but we can accommodate other ages
INCLUDES:
Basic and intermediate riding instruction, grooming, tack
& horse care;
Page 2 of 5
Royal Horseshoe Farm: Summer Camp 2010
601 Morgan Ford Road
Front Royal, VA 22630
(540) 636-6375
E-mail: [email protected]
Put in your date preference(s) (reserved by order of deposit received):
1st date preference:
2nd date preference (optional):
3rd date preference (optional):
________________________
________________________
________________________
Name of Camper: __________________________________________________________
Address: _________________________________________________________________
City: __________________________________________ Zip: _______________________
Home Phone:
___________________________
Age: _______ Weight: ________
Adult’s Cell Phone or Front Royal Area Phone: ___________________________
Adult’s Email: ______________________________________________________________
For minors- Primary Contact (Mother / Father / Guardian (Circle One)):
Name: ___________________________________________________________________
Address: _________________________________________________________________
Home Phone: ________________________ Business Phone________________________
Cell Phone: ____________________________
Business Name: ___________________________________________________________
Business Address: _________________________________________________________
For minors- Secondary Contact (Mother / Father / Guardian (Circle One)):
Name: ____________________________________________________________
Address: _________________________________________________________________
Home Phone: __________________________ Business Phone______________________
Cell Phone: ____________________________
Business Name: ___________________________________________________________
Business Address: _________________________________________________________
Page 3 of 5
Royal Horseshoe Farm: Summer Camp 2010
For Every Camper:
In case of Emergency contact (please provide two names and telephone numbers):
_________________________________________________________________________
_________________________________________________________________________
Physician’s Name: __________________________________________________________
Address: _________________________________________________________________
Phone: __________________________________________________________________
Allergies: _________________________________________________________________
Please list any special health conditions:
_________________________________________________________________________
_________________________________________________________________________
Additional Comments:
_________________________________________________________________________
_________________________________________________________________________
I, ________________________________________hereby authorize Royal Horseshoe
Farm Inc. to secure medical services for:
__________________________________________ (camper’s name), if necessary.
_______________________________________
__________________________
Signature (Parent / Guardian if camper is under 18)
Date
Payment (full payment: $250, minimum deposit: $200):
Make checks payable to: Royal Horseshoe Farm
Credit Card (Visa, Master Card, Discover):
3 digit security code: _ _ _
Card #: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Expiration Date (MM/YY): _ _ / _ _
Billing address (if different from above):
__________________________________________________________________
Amount Authorized: $ ________ Signature: ______________________________
Page 4 of 5
Royal Horseshoe Farm: Summer Camp 2010
Royal Horseshoe Farm Inc.
601 Morgan Ford Road
Front Royal, VA 22630
(540) 636-6375
E-mail: [email protected]
I (/We (all further use of the word “I” includes the case of “we”)):
____________________________________________ (adult camper OR parent / legal guardian of
the following minor camper: _______________________________________________)
certify that I am cognizant of Virginia Code 3.1-796.132 which reads as follows:
Under Virginia law, an equine activity sponsor or equine professional shall not be liable for an
injury to, or the death of, a participant engaged in an equine activity resulting from the
inherent risks of equine activities.
I recognize that horses are unpredictable animals, and that there are significant risks of injury
inherent and associated with horses and horse related activities, including, but limited to trailering,
loading, boarding, riding, grooming, saddling, feeding and caring for horses. Knowing of the inherent
risks, dangers and rigors involved in such horse activities, I certify that I understand the risks
associated therewith, that I am fully capable of participating in said activities, and that I do so at my
own risk.
Royal Horseshoe Farm Inc. and staff require the wearing of protective headgear (hardhat) and
recommend boots or closed-toe shoes with a heel.
I hereby release and hold harmless Royal Horseshoe Farm Inc. and any staff member or
instructor/demonstrator affiliated with Royal Horseshoe Farm Inc. from any responsibility and I
assume the risk for any occurrence related to the summer camp activities, including but not limited to
swimming, hiking, nature studies, horseback riding, arts and crafts etc. which may result in death,
injury, or any other damages. I assume all responsibility for the required physical fitness and ability
to perform, under normal conditions, the rigors associated with horse camp activities.
I further state that I am of lawful age and competent to sign this affirmation and release and that by
signing I understand the terms herein.
In witness whereof I have executed this affirmation and release at:
_______________________ (location) on this _________ day of _________________, 2010.
__________________________________________________________
Signature (Parent / Guardian if camper is under 18)
Page 5 of 5
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