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2025 Camp Registration Form
Our Website
2025 Camp Dates
Registration Fee (Once per Year Only)
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Registration Fee
Multi-Week Discount
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1 Week (No Discount)
2 Weeks
3 Weeks
4 Weeks
5 Weeks
6 Weeks
7 Weeks
8 Weeks
Camp Date(s), If camp is FULL, please call / email for options
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SPRING BREAK CAMP April 14-18
June 16-20 (Horse Day Camp)
June 17-20 (Preschool Camp)
June 23-27 (Advanced Sl)
June 23-27 ( Horse Day camp)
July 7-11 ( Advanced Sl camp)
July 7-11 (Horse Day Camp)
July 14-18 (Horse Day camp)
July 21-25 (Horse Day Camp)
July 21-25 (Advanced Sl)
July 28-Aug. 1 (Horse Day Camp)
July 29-Aug. 1 (Preschool Camp)
August 4-8 (Horse Day Camp)
August 4-8 (Advanced Sl)
August 11-15 ( Horse Day Camp)
August 19-20 (Advanced Sl)
ADULT CAMP JUNE 12-14 (Th-Sa, 6-8:30 pm)
ADULT CAMP AUG 21-23 (Th-Sa, 6-8:30 pm)
Is this your second child registered for the same week of camp?
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Yes
No
Are you paying by Credit Card or PayPal?
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Yes (will add 3% processing fee and charge card/PayPal next step)
No (will pay by check or venmo after registering)
Current Total:
$0.00
Calculate
Extended Care Needed (avail 3-5pm) $15/hour one child. $25/2 children. Must be reserved and prepaid on first day of camp.
Rider Information
First Name
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Last Name
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Preferred Name
Age
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Date of Birth
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Height
Weight
Allergies
Restrictions
Permission to give the following (check all that apply)
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Tylenol
Motrin
Neosporin
Sunscreen
Bug Spray
None
Doctor Name
*
Phone
*
Insurance Name
*
Phone
*
Member Number
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Group Number
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Riding Experience
Please select the following experience levels for each activity
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Never
Working On
Mastered
Walk
Never
Working On
Mastered
Trot
Never
Working On
Mastered
Canter
Never
Working On
Mastered
Cross-Rails
Never
Working On
Mastered
18" Jump Course
Never
Working On
Mastered
2' Jump Course
Never
Working On
Mastered
2'6" Jump Course
Never
Working On
Mastered
Years of Riding Lessons
*
Lessons Per Month
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Years of Riding Camps
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Camps Per Year
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Description of rider's temperament
Friends in Camp
Goals for Camp
Parent / Guardian / Spouse Information
First Name
*
Last Name
*
Street Address
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Address Line 2
City
*
State
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Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
*
Phone Number
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Email Address
*
Emergency Contacts
Name
*
Relationship
*
Phone Number
*
Name
Relationship
Phone Number
Release Waivers
Liability Waiver
I have read the above Liability Waiver and agree to the terms for the rider listed above and the camp dates selected.
*
Yes
I give permission for the rider's picture to be used for Red Gate Farm promotional material.
*
Yes
I give permission for Red Gate Farm's Summer Camp program to transport the rider to field trips (if any) and to seek medical treatment, if necessary.
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Yes
Name
*
Date
*
Signature
*
clear
Enter the word in the image
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