Summer Camp Application - Woodpecker Farm

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 *

$425: Jul 11th - 15th
$425 : July 18th - July 22nd
$100 Deposit: Jul 11th - 15th Balance due the first day of camp. Cash or check only
$100 Deposit: Jul 18th - 22nd Balance due the first day of camp. Cash or check only
Camp Balance

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.

Total

$ 0.00

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