Summer Camp Application (Deposit Only)

Parent's Name *

First

Last

Child's Name *

Please complete this form for each camper.

Child's Age *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email *

Riding Experience *

For example, please specify the years of lessons.

For Advanced Campers: What skills would you like to focus on?

Medical Conditions

Select camp dates

Payment *

If you would like to register for more than one week, please complete this online form again.

Credit Card *

Card Number

Security Code

Name on Card

Expiration/

credit card transactions subject to a 3.5% processing fee.

Vemno

Pay by Venmo to @beth-woodpecker-farm

Venmo

$0.00

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