Rolling Hills Ranch - Day Camp
2016
Web: rollinghillsranch.ca
Each week session is offered at a cost of $285.00 for Kids & Teen Camps & $325.00 for Adult Camps
Space is limited and reserved only after your $100.00 non refundable deposit is received, remaining
funds are due first day of camp. Be sure to make cheques payable to Janice Barry. Camps will run
rain or shine unless other wise stated. Rolling Hills Ranch reserves the right to cancel a session in
which event campers will be offered an alternate choice of summer camp sessions.
Please Circle:
Kids Camp (6 to 12 years of age)
Please Check your session(s): []#1 July 04 – 08 (Kids)
[]#3 August 01 – 05 (Kids)
Teen Camp
Adult Camp
[]#2 July 18 - 22 (Teen)
[]#4 August 15 – 19 (Adult)
Helmet req'd [] ($5.00 per session)
Camper’s Name:_______________________________________________
Circle: Male Female
Age:______ Parents/Guardians Names:_____________________________________
Address: _____________________________City:__________ Postal Code:_______
Home Phone:(____)___________________ Bus:(___)_________________________
Cell Phone:(____)____________ Email:____________________________________
In Case of Emergency call:_______________ Phone:(____)_____________________
Health Card#:_______________Any Medical Problems/Allergies:_________________
Any Special Needs/Emotional/Behavioral Issues: _____________________________
Riding Experience:_____________________________________________________
Date:______________ Parent/Guardian signature:____________________________
Acknowledgment forms will have to be signed by both parent/guardian and child
before participating in camp events.
--------------------------------------------------------------------------------------------------------OFFICE USE ONLY
Kids & Teen Camp Session $285.00 Adult Camp Session $325.00 Helmet Rental $5.00 Yes [] No[]
Total: __________________
Date: __________________
Balance of_______________
Date:___________________
Deposit of__________________ Rec'd by:______________________
[] Cash [] Cheque
[] Cash [] Cheque
Rec'd by:______________________