Summer 2023 Camp Registration
Camper Name
First Name
Last Name
Camper Birthdate
-
Month
-
Day
Year
Campers must be age 6 - 11 during the week they participate in camp.
Please tell us about any disabilities, challenges, or accommodations needed for this camper, if any.
Please tell us about any prior experience with horses this camper may have.
Is the client a current NCTRC client? If an application and medical form dated within the last year are not on file with NCTRC, we will need these completed prior to the date of camp: https://form.jotform.com/212084764325051
Please Select
Yes, this participant is a current client
No, this participant is not yet a client or is a past client and we will complete new paperwork
Is this camper able to manage their own personal hygiene without assistance?
Please Select
No, camper will be accompanied by an assistant.
Yes.
Grownup to Contact
First Name
Last Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Camp Weeks
Categories:
All
All
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Horsemanship Camp, Week 1 (July 10 - 14)
$
300.00
Horsemanship Camp, Week 2 (July 17 - 21)
$
300.00
Horsemanship Camp, Week 3 (July 24 - 28)
$
300.00
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Submit
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