2010 Summer Horsemanship Camp

 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).
           
Please enroll my child in Summer Horsemanship Camp
(mark the date desired)

Week #1

6/14 through 6/18
Week #2 6/21-6/25
Week #3 6/28-7/2
Week #4 7/5-7/9
Week #5 7/12-7/16
Week #6 7/19-7/23
Week #7 7/26-7/30
Week #8 8/2-8/6
Week #9 8/9-8/13
Week #10 8/16-8/20
Week #11 8/23-8/27
 

I understand the fee is $400.00 per Week, and a
non-refundable deposit of $150.00 per week must accompany this registration form. The Balance of $250.00 is due on the first day of camp.
 
(Cash, Check, or Money order.)
           
  Name _________________________ DOB________________
  Parent/Guardian(Print)_____________________________
  Street Address_____________________________________
  City___________________ State___ Zip_________________
  Home Phone____________ Cell________________________
  Emergency Phone_____________________during camp hrs.
  My Child is: Beginning Rider_____
Intermediate Rider_____
Advanced Rider_____
  My Child is allergic to________________________________
           
  Other Health Concerns______________________________
   
   
  _________________________________________________
  Signature of Parent/Guardian
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