Summer Camp Registration Form:   

          Printable PDF  - Summer Camps 2010                                

Please print this form and fill out complete with signature then fax to:  Amberlea Meadows @  780-955-7755 

 

REGISTRATION FORM

 

Student has ridden for __________ years. Student has had riding instruction for ________ years.

 

Summary of students previous riding experience. __________________________________________________________________________________________

 

Essential Equipment – Students require an ASTM Riding Helmet a boot with a riding heel.

 

 CHECK THE WEEK PREFERRED

 

August 16 - 20 Novice Riding - Camp is Full

August 23 - 27 Novice Riding _________        

                                                                       

Please note that space is limited, so please register early!

 

Name               _________________________________________

 

Address           _________________________________________

 

City                 ________________    Prov.    ______________ Postal Code    ______________

 

Telephone        (wk)__________________________       (hm)___________________________

 

A.H.C. #         ____________________________

 

Family Doctor Name and Phone #     ______________________________________________

 

Any allergies/ medical history we should be aware of?

 

This Document will affect your legal rights and liabilities, Please Read Carefully

I acknowledge that the sport of horses is a risk sport and that I am participating at my own risk and in full knowledge of the hazard which are

inherent in this sport. I further acknowledge the inherent risks in riding and working around  horses, which risks include bodily injury to both

horse and rider which can result from normal use, competition, or schooling. It is hereby also understood that no helmet or protective equipment

can  protect against all foreseeable injury.        

In consideration of being allowed to participate in the Amberlea Meadows 2010 Summer Camp, I hereby assume all risk and I hereby release and absolve Amberlea Stables Ltd., their directors, officers, employees, volunteers, and representatives, and their personal  representatives, from all responsibility, liability or claims of any nature and kind which I may have arising from my participation in this activity, including but not limited to bodily injury or death to myself or my horse(s) and damage to  property arising from any cause whatsoever, including the negligence of one or more of the individuals and organizations  referred to herein.                                                                                                                                                                               

                                                                                                                                                                                                             

I hereby declare that in signing this document, that I have read and fully understand and agree to the terms and conditions stated herein and that it is binding upon my executors, heirs and assigns.                                                                                        

                                                          

I acknowledge as parent/ legal guardian of ________________________ that I have read and fully understand and agree to  the terms and conditions stated herein on behalf of the above named child and myself.

                                                                                                                                                                                    

Parent/ Legal Guardian______________________________Date_______________________

 

 

Student Riding Experienc