Full Name:      
Street Address:
City, Prov:       
Postal Code:    
Home Phone:  
E-Mail address:
Birthdate:      Height:      Weight:
Family Doctor      Telephone #      
Health Card No.

T-shirt size:  Youth  S    M     L      Adult  S    M    L

Camper Experience (Please check off the most accurate description of your child’s riding experience and ability).
   Extreme Beginner - Has been on a horse less than 5 times.
   Beginner - Walk, stop and steer, some trotting.
   Novice - Walk, sitting and posting trot, some canter
   Intermediate – Walk, trot, canter with balance and control; some jumping
   Advanced - Walk, trot, canter and jump with confidence and accuracy

Do you have any medical condition, allergies or any other conditions we should be aware of? No   Yes 
If yes, please describe:

- Select Session: 1^st choice    2^nd choice
 Signature of Parent/ Guardian:

____________________________________________________________________

Full name of Parent/Guardian:
Phone # where Parent/Guardian can be reached during the day during camp week:

For Day Camp attach a cheque for $100.00 and a postdated one for $215.  for each week of day camp. 
For Residential Camp attach a cheque for $150.00 and a postdated one for $348.75  for one week of resident camp
For 2 week resident camp attach a cheque for  $200.00 and a postdated one for $745.00
Postdate Cheques for June 15, 2008, for Camps in July and July 15th for camps in Aug.  If paying before Mar 1st 2008 you may subtract $15 from the final cheque.
 Make cheques payable to Teri Lindsay  and mail to:

Teri Lindsay  
1158 Birch Rd  
Gilford, Ontario
L0L 1R0
705-456-5075     866-237-8386  705-455-9166