Summer Camp Application (Deposit Only) Please enable JavaScript in your browser to complete this form.Parent's Name *FirstLastChild's Name *Please complete this form for each camper.Child's Age *AddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhoneEmail *Riding Experience *For example, please specify the years of lessons. For Advanced Campers: What skills would you like to focus on?Medical ConditionsSelect Camp Dates *Woodpecker Camp ($375): Jul 19th - 23rdWoodpecker Camp ($375): Jul 26th - 30thIf you would like to register for more than one week, please complete this online form again.Credit Card *Card NumberSecurity CodeName on CardExpirationMM123456789101112/YY2122232425262728293031Credit card will be charged a non-refundable $100 deposit at time of registration. Balance due in full via cash or check by the first day of camp.Total$ 0.00PhoneSubmit