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Name of Applicant: Address: Town/City: Postal/Zip Code: Phone No.: Age of Applicant: Emergency Contact Persons: 1. Phone: 2. Phone: Physician: Phone: Any medical conditions we should know about? Presently taking any medication? Health Care Insurance Number Please check off the appropriate camp: Camp Week 1 Date: _______________ Camp Week 2 Date: _______________ Camp Week 3 Date: _______________ Youth Rider Advanced Camp 5 days Camp Week 4 Date: _______________ Centered Riding Workshop Camp Week 5 Date: _______________
Riding Experience?
Costs listed below for various camps are in Canadian Funds. Cost of the General Camp is $395.00 + $27.65 (GST) = $422.65. A deposit of $100 must be included with this form to register for this camp. Cost of the Youth Rider Advanced Camp is $595 + $41.65 (GST) = $636.65. A deposit of $200 must be included with this form to register for this camp. We also offer all girls or all boys camps. Enrolment must be 6 or more. All camps include 3 to 4 hours of riding each day, rain or shine, plus stable management. 10% referral discount to bring a friend or sibling, no extra charge to bring your own horse. Pre-order the Rider Level Manuals from Alberta Equestrian Federation at 1-800-463-6233 or on line at http://www.albertaequestrian.com/ Payment is by cheque or money order only. The deposit must be included with this registration form and is transferable but not refundable. If you pay for the course in full upfront we will reduce your fees by 10%. Registration will be on a first come, first serve basis. Misconduct of the registrant will result in being expelled with no refund of camp fees. No smoking or drinking is allowed on the premises.
The undersigned participant(s) and his/her/their guardian(s) recognize the dangers inherent to all activities involving horses. Therefore the undersigned participant(s), parent(s) and/or legal guardian(s) do hereby release and discharge Lakewood Equestrian Centre, instructors, owners, trainers, and employees from any and all causes of action, including those resulting from any and all known bodily injuries and/or property damage resulting from the actions and/or omissions of the above-named herein. We agree to hold those named above and herein harmless and to assume the risk of personal injury, death, or property loss whether or not such injury may be caused by a perceived negligence of those peoples and/or agents named above and herein. If we bring our own horse, or a loaned horse, we will assume all responsibility and risk boarding the horse at the stable, or actions taken by his/her horse causing damages and/or injury to persons or property while staying at the stable. The participant's equipment and articles are left at the stable at the participant's risk. Signature of rider: Print the name of the rider: Signature of horse owner or agent: Signature of parent or guardian if the rider is under 18 years of age:
Monday arrival time is 9:00 a.m. Friday departure time is 5:00 p.m. For out of town riders, you may arrive Sunday after supper. Each child should bring:
Make sure to mark all items brought to camp. If you bring your own horse, please supply your own grooming utensils, water buckets, horse clothing and applicable tack/saddlery. The horse should be up to date with vaccinations, parasite treatments and have the results of a negative Coggins test. Friday will offer exams for those who wish to be certified rider (CEF) level 1 or 2 (For Advance Youth Camp Only).
Lakewood Equestrian Centre
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