Summer Camp Preregistration for Returning Campers

Camper Name*

Age

6
7
8
9
10
11
12
13

Parent/ Guardian Name*

Phone*

Email*

Address*

Street Address Address Line 2 City State ZIP Code

T-Shirt Size*

Size*

Small
Medium
Large
XLarge

Emergency Contact

Person to be notified in case of emergency (please list two):

Contact 1 Name*

First Last

Phone during camp hours*

Relationship to camper*

Contact 2 Name*

First Last

Phone during camp hours*

Relationship to camper*

Who will pick up the camper?*

List any allergies

List any medications taken in a regular basis

Physician's name

First Last

Physicians phone number

Medical Care*

In the event of an accident or if your child becomes ill, we will notified who has been listed on the emergency form. if we are unable to contact anyone and we feel that your child needs medical care, do you give us permission to seek medical help?

YES
NO

Consent*

I agree to this policy.

I agree that I shall indemnify and hold harmless Land of Little Horses Theme Park against any liability for all claims and damages to property of or person arising out of resulting from the conduct and activities of the camp and representatives. I grant Land of Little Horses Theme Park my permission to use photographs and video taken at camp for any legal use including but not limited to publicity, copyright purposes, illustrations, advertising, web and social media content.

Please be sure to submit both the registration form and your payment*

Okay

week of camp preferred*

Week #4 - July 11th - July 15th

Summer Camp 2024 Preregistration for Returning Campers

Price:

Credit Card

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name