Name: Birth date:

Street Address or PO Box:

Town/City State: Zip:

Home Phone: Work phone:   Email:

Parents/Guardian:  

Previous riding experience:
 

Session Requested: (Campers may attend multiple sessions.)

Session 1:  June 25 - June 29
Session 2:  July 9 - July 13
Session 3:  July 16 - 20