WINDY MEADOWS HORSE FARM
CAMP REGISTRATION

WINDY MEADOWS HORSE FARM, 12829 LEMASTER DRIVE, NOKESVILLE, VA. 20181
(571) 437-6051   E-MAIL ADDRESS horsey24@hotmail.com

Please Select Option:      One Day      Three Days      One Week
Camp Dates:
Child's Name:
     DOB:
     AGE:
Address:
     City/State/Zip:
    
Parent Name:
     Phone (H):
(W):
     (C):
    
Parent Name:
     Phone (H):
(W):
     (C):
    
Emergency Name:
     Phone (H):
(W):
     (C):
    
Allergies:
     Child's Height:
     Child's Weight
Riding experience: (How long ago? English or Western? Lessons? Camp? Trail Rides?)
General description of child's temperament:
Friends in camp:
Goals of camp:
Extended care needed:
Any other info that may be helpful:
    
Permission to give the following (check all that apply):
 Tylenol      Motrin      Neosporin      Sunscreen      Bug Spray
Restrictions:
Doctors Name:
     Phone:
Insurance Name:
     Phone:
Member #:
     Group #:
Email address:
    
I give permission to my child to participate in Windy Meadows Horse Farm Camp Program and seek medical help if necessary.
Parent or Legal Guardian*
     Date:
(*) Note: Signature and Date to be hand written...