REGISTRATION FORM
 
MAIL TO:
 
VERDI TRAILS WEST, INC.
P.O. BOX 972 VERDI, NV 89439
Please return your Registration Form along with your fees as soon as possible. We will make every effort to accomodate your first choice of week(s).
           
           
 
(Cash, Check, or Money Order. No Credit Cards)
           
  Name _________________________ DOB________________
  Street Address_____________________________________
  City___________________ State___ Zip_________________
  Home Phone____________ Cell________________________
  Emergency Phone_____________________during camp hrs.
  I am a Beginning Rider_____
Intermediate Rider_____
Advanced Rider_____
  I am allergic to___________________________________
           
  Other Health Concerns______________________________
   
   
  Signature______________________________________
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