Registration Form for Seattle Pony Party Day Camp

Please print out and mail to 4524 NE 190th ct, Lake Forest Park, Wa, 98155

remember to include your liability waiver

Please fill out a separate form for each camper and mail together for the multi-camper discount

Name of Camper_____________________________________________

Home address of Camper ______________________________________
  _______________________________________

Names and phone numbers of all Parent/Guardians allowed to pick up Camper
(these are also your camper's Emergency Contacts)

 Name 1 _________________________ Phone 1 ________________

 Name 2 _________________________ Phone 2 ________________

 Name 3 _________________________ Phone 3 ________________

Select session(s)

Dec 14-18

Dec 21-23

Dec 28 - Jan 1
 
 
Approximate skill with Horses (please check)
 __ Novice: new around horses, not yet at beginner level
 __ Beginner: comfortable around horses, rides without lead-rope at the walk
 __ Intermediate: able to groom and saddle ponies, rides at the trot
 __ Advanced: competent at basic horse care, rides at the canter

Age and weight: ______yrs, _______lbs (camper must be at least 5-12yrs old and no more than 120lbs weight)

Medical or other Issues we should be aware of:

Extended Hours requested for this camper

(Available hours are drop off at 8am and pick up by 5pm)

 Monday ______________________
 Tuesday ______________________
 Wednesday ______________________
 Thursday ______________________
 Friday ______________________
 Total Hours ______________________

Total Camp Fee (for 5-day session; prorate for shorter sessions):
Camper at $400 (or if you have multiple campers $360 each) ______

Extended hours @ $10 per hour ______
 Total Fee ______

Please send with a deposit of $150 per camper to

 Seattle Pony Party
 4524 NE 190th CT
 Lake Forest Park WA, 98155

Payment should be by check made payable to Seattle Pony Party