No School Day Camps 2022=2023 Early Drop Off/Late Pick Up Request Form

The Horses4Heroes Family Equestrian Center

No School Day Camp Early Drop Off/Late Pick Up

Request Form 2022-2023

One form per family
Camper Name
First Name
Middle Name
Last Name
Camper's Information
Address
City
State
Zip
Home Phone

Area CodePhone Number
Emergency Contact Name(if parent or guardian is not available)
Emergency Number

Area CodePhone Number
Emergency Number #2

Area CodePhone Number
Birth Date (must be four or older)

MonthDayYear
Camp Attending
Early Drop Off, 7 am to 7:45: $10 per camper; check in opens at 8 AM, camp starts at 9 AM
Late Pick Up, 3:30 pm to 5:00 pm: $10 per camper.
Parent or Legal Guardian Information
Parent/Legal Guardian
Relation
Work Phone

Area CodePhone Number
Cell Phone

Area CodePhone Number
Parent /Legal Guardian 2
Relation 2
Work Phone 2

Area CodePhone Number
Cell Phone 2

Area CodePhone Number
Email Confirmation
Parents Email
Camper's Email
Camper Release
Camper Release (List anyone, including parents, to whom your camper can be released)
- Be certain to enter your email address correctly on the registration form to receive confirmation via email with in 2 weeks
Release/Waiver of Liability

This form releases the directors of Horses4Heroes, Inc, a Nevada non-profit corporation, operating at 4975 North Miller Lane, Las Vegas, NV from all liability, due to injury, death, illness incurred in the pursuit of equestrian activities by the undersigned. It is to be understood by the undersigned, or guardian thereof that the handling, riding driving, and care of horses is an inherently dangerous and risky activity. With this understanding, the undersigned may not hold aforementioned parties accountable for any injuries sustained while pursuing equestrian activities (riding, jumping, trail riding, arena riding, etc.).
Name of minor child:
Signature
Electronic signature, please initial
Should be Empty:

Camper Name

Camper's Information

Parent or Legal Guardian Information

Email Confirmation

Camper Release