2015 Summer Camp Registration Form Child’s Information Name: ______________________________________________________________ Age: ___________ Birth Date: __________________________________________ Medical Conditions/Allergies: ___________________________________________ ____________________________________________________________________ Skill Level T-Shirt Size (Adult) ___ Never Ridden Before ___ Beginner ___ Advanced Beginner ___ Intermediate ___ Advanced ___ XS ___ S ___ M ___ L ___ XL Session ___ Session I: June 8 – June 12 ___ Session II: June 15 – July 19 ___ Session III: July 6 – July 10 ___ Session IV: July 13 – July 17 Contact Information Address: ___________________________________________________________ City: _______________________________________ State: _____ ZIP: ________ Home Phone: _______________________________________________________ Father’s Name: ___________________________ Cell Phone: ________________ Mother’s Name: __________________________ Cell Phone: ________________ Email Address: _____________________________________________________ Emergency Contact (if different): _______________________________________ __________________________________________________________________ Medical Release I agree that the child listed above has my permission to ride and participate in activities at Forever Green Farm Summer Camp. I understand that horses can be unpredictable and riding can be a dangerous sport. I hereby release Keedle RitterKonopka, Forever Green Farm Riding Academy, and all instructors and assistants from any responsibility of injury that might occur on or around these horses. Signature: __________________________________________________________ Date: ______________________________________________________________ Camp Information Cost: $250.00/week, $225.00/week if paid in full by April 1, 2015. Additional discounts available when registering for multiple sessions – please call for more information. $150.00 deposit required with registration form with balance to be paid in full by first day of camp. Location: Forever Green Farm Riding Academy is located at 2612 S. English Station Road in Louisville, KY. Who Can Attend: Any child age 5-13, beginner to advanced is welcome. Each session is limited to the first 25 registrations received with a 50% deposit. Safety: Safety is stressed at all levels with the use of helmets, safety stirrups, wonderful, experienced lesson horses, and qualified instructors and assistants. What to Bring: Campers should come dressed to ride each morning of camp. Please send a sack lunch and snack for each day. They should also bring sunscreen and plenty of water/Gatorade/etc. each day. A change of clothes (shorts) for afternoon activities is optional. Curriculum: Campers will ride twice a day, participate in “horsey” arts and crafts, barn games, scavenger hunts, horse painting, and other activities centered around horses. Campers will also learn all aspects of horsemanship and horse care including: parts of the horse, types of tack and equipment, how to groom, bathe, and tack up a horse, what horses eat, when to call the vet, farrier or other equine care professional. In the saddle, campers will focus on the fundamentals, mixing a variety of fun activities and exercises designed to improve balance and control. Each week will also include a visit from an equine professional (vet, farrier, dentist, chiropractor, etc.) for a hands-on demonstration. Friday of each camp session will be a “show off day” in which parents, family, and friends are encouraged to come to watch and cheer on their favorite rider as they show off the new skills they learned at camp. Time: 9:00 AM – 4:00 PM, Monday – Friday of each session. Early drop offs (7:45-8:45 AM; $10.00/day) and late pick ups (4:15-6:00 PM; $10.00/day) can be accommodated. For more information or for any questions, contact: Keedle Ritter-Konopka (502) 645-9869 Mail registration forms with deposit to: Forever Green Farm 2612 S. English Station Road Louisville, KY 40299