December 27th-29th

January 3rd-5th

Afternoon 1pm-4pm $400
Camper Information
Camper's Name*

First NameLast Name
Birth Date*

MonthDayYear
Gender

MaleFemale
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Parent/Guardian Information
Name*

First NameLast Name
Cell Number*

Area CodePhone Number
E-mail*
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/venmo for the registration fee. Balance due of $400 must be paid the first day of your desired session. You can write a check, pay cash or use venmo. 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:

January 3rd-5th