Youth Camp Application
D - TALK RANCH CAMP APPLICATION
Name of camper:___________________________
Date of birth:_____/_____/____
Address:__________________________________
City:___________________ State:______Zip: ____________
Father's name:_________________ Phone: (h)__________ (w) __________
Mother's name:_________________ Phone: (h) _________ (w) __________
Guardian signature________________________________________
Contact in case of emergency:_______________________________
Phone: (h) __________(w) ___________
Medical conerns:__________________________________________
Our strong emphasis on safety requires all students to wear boots and AST- approved Helmets, and long pants.
Camp dates desired:
Level of riding experience (please circle)Beginner Intermediate Advanced Showing
Number of years riding:______________________________
FEE: $300.00 FOR THE 4 DAYS
DEPOSIT, $100.00 MAKE CHECK PAYABLE TO D-TALK RANCH
For a printable version of this application,
|