Farm Camp Application
Summer 2024
Name
First Name
Middle Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Gender
Male
Female
Email
example@example.com
Phone Number
Mobile Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Camper T-shirt Size
Child S
Child M
Child L
Child XL
Adult S
Adult M
Adult L
Camp Session
June 10-14
June 24-28
July 8-12
July 29- Aug 2
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Medical Information
Please note: Campers must weigh under 250lbs fully dressed with boots
This is for the safety and well-being of our horses.
Does the camper have allergies including asthma?
Please explain on the field provided
Is the camper currently under medication?
Please provide the details, the name of the medication and period of intake
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Contact Information in Case of Emergency
Name
First Name
Last Name
Contact Number
-
Area Code
Phone Number
Relation to camper
Name
First Name
Last Name
Contact Number
-
Area Code
Phone Number
Relation to camper
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Payment
Signature of applicant or guardian representative
Submit
Submit
Should be Empty: