2023 Discovery Trail Summer Camp Registration

June 19-22 – JUNIOR EXPLORERS – Ages 4-6 • 10a-12:30p [cancelled]

June 26-29 – DISCOVERY TRAIL CAMP :: 1 – Ages 7-11 • 9a-1:00p

July 17-20 – DISCOVERY TRAIL CAMP :: 2* – Ages 8-12 • 9a-1:00p

July 24-27 – JUNIOR EXPLORERS – Ages 4-6 • 10a-12:30p

*Level 2 is designed for those participants who have joined us for a previous camp or nature-based/equine-assisted learning program and are ready for more!

We will require a minimum number of 6 campers to hold a week of camp. Maximum of 12 spots. Full refunds will be provided if we cancel a week due to low enrollment.

Please note: this is not a horseback riding camp.

DETAILS: www.rcdiscoverytrail.org/camp

Please complete one form per camper. If you have siblings who would like to attend, a separate form must be completed for each camper. Items with an asterisk* are required.

All camps take place at Rocky Creek Ranch, home of The Discovery Trail in Statesville, NC {easy off I-77}. Complete details including directions and parking, will be provided upon receipt of registration. Questions? info@equuvation.org

• • • • • • • • • • • • • • • • • • Camp Selection • • • • • • • • • • • • • • • • • •

Camp Weeks:

Junior Explorers – Discovery Trail Camp for Littles$120.00

Junior Explorers – Discovery Trail Camp for Littles {Mon-Thu} June 19-22, 2023 • 10a-12:30p daily For ages 4-6 - $120 per camper for the week

Quantity

Discovery Trail Camp :: Level 1$185.00

Discovery Trail Camp :: Level 1 {Mon-Thu} June 26-29, 2023 • 9a-1:00p daily For ages 7-11 - $185 per camper for the week

Quantity

Discovery Trail Camp :: Level 2*$185.00

Discovery Trail Camp :: Level 2* {Mon-Thu} July 17-20, 2023 • 9a-1:00p daily For ages 7-11 - $185 per camper for the week *This camp is designed for those participants who have joined us for a previous camp or nature-based/EAL program.

Quantity

Junior Explorers – Discovery Trail Camp for Littles 2$120.00

Junior Explorers – Discovery Trail Camp for Littles {Mon-Thu} July 24-27, 2023 • 10a-12:30p daily For ages 4-6 - $120 per camper for the week

Quantity

Total $0.00

Following submission of this form, you will be directed to Paypal to complete your payment, which will hold the spot for your camper. All payments go through our 501c3 nonprofit organization by the name of Equuvation Inc., the parent company of The Discovery Trail at Rocky Creek. In the event that your child is unable to attend camp: All refunds are subject to a $25 cancellation fee. Refunds will be given if requested at least 14 days before your week of camp. If you cancel less than 14 days before your week of camp, refunds will be given only for medical reasons or a family emergency.

• • • • • • • • • • • • • • • • • • Camper Profile • • • • • • • • • • • • • • • • • •

Camper Name {First, Last}*

Camper Gender

Camper Date of Birth*

Camper Rising Grade Level*

School Name*

School Location {Town}*

Camper Preferences {please check all that apply!}*

Please feel free to elaborate on your camper's preferences. {What sports does he/she play? What type of animals does he/she like best? etc.}

Does your camper have siblings? Please describe.

Does your camper have pets? Please describe.

Additional details you would like to share about your camper:

• • • • • • • • • • • • • • • • Parent/Guardian Info • • • • • • • • • • • • • • • •

Parent/Guardian Name {First, Last}*

Parent Email*

example@example.com

Parent Phone {Mobile}*

Area CodePhone Number

Parent Phone {Home}*

Area CodePhone Number

Parent Phone {Work}*

Area CodePhone Number

Parent Address {should also be main residence for camper}

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

EMERGENCY CONTACT :: Please list the NAME, PHONE, EMAIL and RELATION for one additional emergency contact for this camper*

If there is the possibility that another friend or member of your family will drop off or pick up your camper, please list their names here. We will not allow a camper to travel with anyone who is NOT listed below:

• • • • • • • • • • • • • • • • • • • • Medical Info • • • • • • • • • • • • • • • • • • • •

Camper Allergies {please check all that apply}*

Environmental {i.e. pollen, trees, grass, hay}Bee/Wasp StingsAnimals {i.e. dogs, cats, horses, birds}Dietary {i.e. nuts, dairy, fruit, soy, chocolate, shellfish}NONE THAT WE ARE AWARE OF

Camper Allergies :: PLEASE EXPLAIN/CLARIFY ANY OF THE ALLERGIES YOU MAY HAVE SELECTED ABOVE -- be specific!

Does this camper carry an Epi-Pen?*

YesNo

If "YES" to the question above, does this camper know how to use their own Epi-Pen?

YesNo

If "YES" to the question above, has this camper used his/her Epi-Pen in the last 6 months?

YesNo

Please list any known MEDICAL CONDITIONS, SPECIAL NEEDS or other HEALTH CONCERNS that we should know about:

• • • • • • • • • • • • • • • • • Acknowledgements • • • • • • • • • • • • • • • • •

By putting your initials in the box below, you agree to sign a Liability and Release Form prior to the first day of this program for your camper to participate. [Forms will be sent via EverSign for electronic signature]*

Thank you for completing this form! You will receive a confirmation email within 48 hours of submission. If the camp is full, you will be provided with a number on our Wait List and your payment will be refunded in full.

Questions? info@equuvation.org