Use this registration form to register for any of the Roselawn Stables camp programs.
Please read the form carefully.
Send the completed form and any registration fees to the address below.
WAIVER OF LIABILITY
PLEASE READ CAREFULLY Date: _______________
By signing my name below, either in person or by one of my representatives, I hereby agree to comply with all of the terms and conditions stated above.
I HAVE CAREFULLY READ THIS WAIVER OF LIABILITY AND RELEASE. I UNDERSTAND IT, AND VOLUNTARILY AGREE TO ALL OF ITS TERMS.
CHILD NAME __________________________ PARENT SIGNATURE ___________________________
___ Basic Camp ___ Intermediate Camp ___ Explorers Camp ___ Home School Camp
Child’s Name ____________________________________________________________________________
Mother/Father’s Name _______________________________________ Phone (H) ____________________
Address __________________________________________________ Phone (W) ____________________
City ______________________ State _________ ZIP ____________ Phone (Cell) __________________
Age at Camp Date ______ Grade Completed ________________ Phone (Cell) ___________________
Camp Date First Choice ______________________ Camp Date Second Choice ______________________
How did you hear about Roselawn Stables? ___________________________________________________
A $100 non-refundable deposit must accompany this registration. Any monies received above the deposit may be transferred to a different camp date but will not be refunded. Balance due on the first day of camp.
T-Shirt size (circle one) Youth: 10/12 14/16 Adult: S M L XL
MEDICAL RELEASE FORM
If I cannot be reached, I give permission to the physician selected to hospitalize, secure proper treatment for, and order injection, anesthesia or surgery for this child.
Any allergies? ____________________________________________________________________