Camp Caballo

Last Name*

First Name*

Middle Name*

MaleFemale

Address*

City*

State*

Zip*

Birth Date*

MonthDayYear

Grade entering in the fall*

yesno

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

Home Phone*

Area CodePhone Number

Emergency Contact Name(if parent or guardian is not avaliable)*

Emergency Number*

Area CodePhone Number

Emergency Number #2*

Area CodePhone Number

Parents Email (camper confirmation will be sent by email, if left blank it will be mailed)

Camper's Email

How did you hear about Camp Caballo?

YesNo

Any activity the camper should be restricted from?

Any physical, mental or other condition that would require special attention or medication while at camp?

List all medications, both prescribed and over the counter, all medications will be turned into the health officer except rescue inhalers, bring all medication in original containers.

List any allergies (ex: bees,peanuts, dairy)

Any dietary needs that we should know about?

YesNo

CashCheckVenmo (@TheBarnLC)Cash App ($TheBarnLC)

By hitting submit and your electronic signature, you agree that you are the parent or legal guardian of the above named camper, and are over the age of 18. In case of medical emergency or general medical care, I give consent for medical teatment for the aboved named camper by authorized personnel. I certify that my child has my permission to attend camp and participate in all activites (horseback riding) and hereby release and forever discharge Camp Caballo / The Barn of Lake City / Andrews' Acres located at 1008 Old Wire Rd and 10170 SW Tustenuggee Ave respectively, their affiliates, managers, members, staff, volunteers (collectively 'Releases") from any physical or psychological injury that I/They may suffer as a direct result of My/Their participation in the aforementioned Activity. I am voluntarily participating in the aformentioned activity and I am participating in the activity at my own risk. I am aware of the risks associated with participating in this activity, which may include, but are not limited to: Physical or Psychological injury, Pain, Suffering, Illness, Disfigurement, Temporary or Permanent Disability (including paralysis) and death. I understand that these injuries or outcomes may arise from my own or others negligence, conditions related to travel to and from the activity or from conditions at the activity location(s). Nonetheless, I assume all related risks both known and unknown to me, of my participation in this activity.

Electronic signature*

Camp Caballo Registration

Camper's Information

Parent or Legal Guardian Information

Emergency Contact Info

Email Confirmation

Other Information

Health Information

Camper Photo Release

Payment Information