Equilibrium Winter Camps 2025

Camper Name*

First NameLast Name
Gender
Age at Camp (Must be 5 and up)*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/ Legal Guardian Name*

First NameLast Name
Parent/Legal Guardian Email*
example@example.com
Parent/Legal Guardian Cell Number*
Please enter a valid phone number.
Parent/Legal Guardian Work Number
Please enter a valid phone number.
Name of individual(s) other than above authorized to pick up camper:

(IF APPLICABLE)
Authorized Person

First NameLast Name
Authorized Person Cell Phone
Please enter a valid phone number.
Emergency Contact Name *

First NameLast Name
Relation to Camper*
Emergency Contact Cell Phone*
Please enter a valid phone number.
How did you hear about our camp?
Does your camper have any experience with horses? If Yes, please describe:
To help your camper have a great camp experience, is there any additional information about them you would like us to know?
Does your child have any allergies, medical or otherwise? If yes, please list below. If no, please type "no known allergies" below.*
If you need to cancel your registration for camp, please contact us at libby@terranovaequestrian.com as soon as possible. If you cancel more than 30 days prior to your camp starting, you will receive a refund minus a $50 administrative fee. If you cancel less than 30 days prior to your camp starting, you will not receive a refund or credit. If camper cannot attend due to illness or injury, we will gladly credit towards another Equilibrium camp or our other lesson programming.*

I understand this policy and wish to proceed.
Gift Certificates are available! If you would like to have your order in the form of a gift certificate, please select below
I would like a gift certificate the following way:

In a wrapped box to be picked up at TerraNova Show OfficeEmailed to me for downloadI do not need a gift certificate

Camp Dates (If paying for more than one camper, please complete separate form for each)*

Dec 22nd Mini Horsemanship Winter Camp

$125.00 Quantity

Dec 29th Mini Horsemanship Winter Camp

$125.00 Quantity

Dec 30th Mini Horsemanship Winter Camp

$125.00 Quantity

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Release and Waiver of Liability, Assumption of Risk and Indemnity.
TerraNova Equestrian Center's Release and Waiver of Liability, Assumption of Risk and Indemnity may be executed by electronic signature in accordance with Florida law, and electronic signatures appearing on this agreement are the same as handwritten signatures for the purposes of validity, enforceability, and admissibility.
Signature TerraNova Release and Waiver of Liability*

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Name of individual(s) other than above authorized to pick up camper:

Gift Certificates are available! If you would like to have your order in the form of a gift certificate, please select below