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just print out the application below and send it to us |
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2010 Summer Program Application |
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| A child may select ONE friend the would like to be grouped with | Parent Agreement |
| if possible _____________________________ Age ________ | I understand the inherent risk of riding horses and accept |
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One Application per Child
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responsibility for my child for that risk. |
| ______________________ ___________________ | ___________________________________________ |
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Child's First Name Last Name |
Parent Signature |
| ___________________________________________ | |
| Parent's Name | 2009 Sessions - Please Check Appropriate Box(es) |
| ___________________________________________ |
 1st : June
21 - July 2
2nd : July 5 - July
16 |
| Address | |
| ___________________________________________ |
3rd : July
19 - July 30
4th : Aug. 2 - Aug.
13 |
| City / State / Zip Code | See Fees and Multi-Child Discount Info. |
| _____________________ ____________________ | Questions? Please call (215) 598-8503 |
| Phone Number Emergency Number |
Transportation Needed:
Yes
No ($75 a week) |
| Grade in September________ Age at Program Date _______ | Deposit________ Date Received _______ Check No.______ |
| Any Special Needs __________________________________ | * A $300 deposit is required with each application. (Cancellations are accepted until June 1st less deposit) All fees must be paid by May 15th or incur penalty. Due to scheduling requirements, no refunds after May 1st. |
| *No children can be accepted during the second week of any session | |
