December 27th-29th

December 27th-29th

Afternoon 1pm-4pm $395
Camper Information
Camper's Name *

First Name Last Name
Birth Date *

Month Day Year
Gender

Male Female
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Parent/Guardian Information
Name *

First Name Last Name
Cell Number *

Area Code Phone Number
E-mail *
Emergency Information
Emergency Contact's Name *

First Name Last Name
Relationship *
Phone Number *

Area Code Phone Number
Alt. Phone Number

Area Code Phone Number
Does the camper have any allergies, chronic illness, or medical conditions? If yes, please describe.
Same group friend request? Notes?
A $25.00 non-refundable registration fee per child is required with the registration form to reserve your spot. You may write a check or use paypal for the registration fee. Balance due of $395 must be paid the first day of your desired session. You can write a check or pay cash. Make checks payable to: Ride With Pride, Inc. 480 West Highland Southlake, Tx 76092. Ride with Pride reserves the right to cancel a camp that does not meet the minimum number of students.
Pay by check
Should be Empty: