Bridgette Harwood
Summer Riding Camp Registration Form

516-425-0693

Child's Information
Full Name
Age ( 6 - 19 )
   
Height & Weight
Riding Experience
   
Food or Other Allergies
Medical Conditions


Parent / Guardian
Full Name
Full Address
   
Home Phone
Cell Phone
   
Email
Work Phone
   


Emergency Contact
Full Name
Home Phone
   
Cell Phone
Work Phone

Type of Camp
Dates
Jun 26- Jun 29
Jul 3 - Jul 6
Jul 10 - Jul 13
Jul 17 - Jul 20
Jul 24 - Jul 27



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