Summer Camp Horse Back Riding, Registration

Rider's Name:

Permanent Address:

Summer Address (if different):


M/F:			Age:
Height:			Weight:

Parent's Name:

Street:

City:

State:

Zip:

Phone:

E-mail:

Street:

City:

State:

Zip:

Phone:

E-mail:


Any allergies, disabilities or illness:		Please give a brief description of the child's experience with horses:

Space is limited reservation required.

Program Fee is $225 per week. A $125 non-refundable deposit per child
per week is required with application in order to reserve you space.

Please mail registration and check to:

Ginna Riker
1037 New York Avenue
Cape May, NJ 08204

2011 Week(s) Requested to Attend

	June 20 - 23		August 1 - 4
	June 27 - 30		August 8 - 11
	July 4 - 7		August 15 - 18
	July 11 - 14		August 22 - 25
	July 18 - 21		Aug. 29 - Sept. 1
	July 25 - 28* Advanced riders only.

Release: (This section must be hand-signed)

Date: ______________________

It is hereby acknowledged and understood that Horseback riding is a dangerous activity. (I) (We) the undersigned, as parents or legal guardians of ________________________ from this date on, hereby release and hold harmless HVR LLC and/or Sea Horse Farm LLC & their employees, from any damages that may occur as a result of any injuries sustained while taking horseback riding instruction on the property of Seahorse Farm LLC,. This shall include all losses, damages, costs and counsel fees that may occur as a result of injury, and related claims by any parties.

I understand risks are involved in horseback riding and working with horses and ponies, and by signing this agreement take full responsibility for (my) (our) child in the event of any injury.

(I) (We) have read this release, and understand it terms and sigh it voluntarily and with full knowledge of its significance.

Parent’s Signature: ______________________________________

Legal Guardian's Signature: _______________________________

Witness: ______________________________________________

Fill in the form & click the "Print Registration" button. Mail to the address below.

Horse Back Riding Summer Camp Registration: