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Registration for Horse Camp
Rider's Name *

First Name Last Name
Rider's Age *
Parent's Name (if under 18)

First Name Last Name
Email *
example@example.com
Phone Number *
Please enter a valid phone number.
Desired Camp *

Adult Camp - Summer - June 9-11, 2022 Kids Camp - Summer #1 - June 14-17, 2022 Kids Camp - Summer #2 - June 28-July 1, 2022 Advanced Kids Camp - July 12-15, 2022 (Approval Required by Al) Kids Camp - Summer #3 - July 19-22, 2022 Kids Camp - Fall Oct 2022 (Dates TBD) Adult Camp - Fall Nov 2022 (Dates TBD) Kids Camp - Winter Dec 2022 (Dates TBD) Adult Camp - Spring March 2023 (Dates TBD) Kids Camp - Spring March 2023 (Dates TBD)
I would like to purchase a shirt for my rider. *By selecting the size below you agree to pay an additional $25 for Camp Shirt* *
Adult & Kids Camp Refund Policy...If refund is requested, funds may be transferred to lessons scheduled schedule, and must be used within one year of purchase date. Funds can also be transferred to another camp, but transfer can only occur once. No cash refunds available. Funds can also be transferred to another participant if client wants to. *

I understand the Refund Policy I have questions about the policy I disagree with the policy Other
Participant Release - Known by all present: The undersigned understands and agrees that there is inherent risk of injury in all equine-related activities, both mounted and non-mounted. It is understood that horses may stumble, bite, run, or make unpredictable movements which may cause a participant to be injured by or fall from the horse. I am willing and able to accept full responsibility for my own safety and welfare and my family’s. I do hereby release and discharge Al’s Horse Academy, it’s instructors, staff, volunteers and horse owners from any and all responsibility or liability to me, my child, or my family in connection with any injuries or disease suffered by me, my child, or my family as a result of my activity, participation and attendance involving Al’s Horse Academy horses/ponies, property or events. *

I agree to the Participant Release for my child, myself and my family I have questions about the Participant Release Other
Photo Release - I hereby grant Al’s Horse Academy and all entities permission to use any and all photographs, slides and any other audio visual materials in which I may appear for the express purpose of promoting Al’s Horse Academy programs and I do not expect, nor shall I receive any monetary reimbursement for this authorization. *

I agree to the Photo Release Other
Medical Information for Participant - Please let us know below if participant has any medical or allergy conditions we need to know about. This includes ADHD, Autism, allergic to anything, etc. This will help our staff keep all riders safe. If medication is needed please give it to Management with name clearly printed with directions for application. For participants who develop allergies while at Academy, the participants' affected area will be washed. Then the Academy will contact the parent/guardian for further instructions. If Academy is administering medication per your permission, and the participant is exhibiting allergy symptoms including, but not limited to: facial swelling, other excessive swelling or trouble breathing, or if another emergency occurs which Management believes requires a 9111 call, Academy will call 911 before contacting the parent/guardian. The parent/guardian accepts full medical financial responsibility for the participant. *

The participant has a medical condition described below The participant has an allergy described below The participant is healthy, with no medical or allergy conditions Other
Medical or Allergy Conditions
Emergency Contact - if other than parent information above

First Name Last Name
Emergency Contact Phone Number - if other than parent information above
Please enter a valid phone number.
How will you pay? *

Credit Card/Debit Card Below Cash Check Other

My Products

Kids Camp Enter description

$ 190.00

Kids Camp Early Bird OR Gift Certificate Discounted This option for those campers with a Gift Certificate from previous camps OR Early Bird Registration 14 days prior to camp start date.

$ 175.00

Kids Camp Early Bird AND Gift Certificate Discounted This option for those campers with a Gift Certificate from previous camps AND Early Bird Registration 14 days prior to camp start date.

$ 160.00

Adult Camp

$ 150.00

Camp T-Shirt Must pay here in order to receive order.

$ 25.00

Total

$ 0.00

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Registration for Horse Camp

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