Summer Camp Enrollment Form

Bryant Manor Equestrian Center Summer Camp Registration

My Products *

product

2-Day Camp $ 130.00

Camp is $65 a day, 2 days must be purchased at minimum. Please include which days your selecting in the registration form below.

product

4-Day Camp $ 215.00

Camp is $53.75 a day, 4 days must be purchased at minimum. Please include which days your selecting in the registration form below.

Total $ 0.00

Credit Card

CHILD INFORMATION:
Child Name *

First Name Last Name
Age *
Birth Date *

Month Day Year
PARENT/GUARDIAN INFORMATION:
Parent/Guardian Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number *
E-mail *
example@example.com
Emergency contact

First Name Last Name
Emergency Phone Number
MEDICAL INFORMATION
Physician Name

First Name Last Name
Physician Phone Number
Medical Concerns (Allergies, Medications, etc)
Horse experience

Beginner Intermediate Experienced
Signature

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Should be Empty: