OLYMPIC PENINSULA PERFORMANCE HORSES
2012 ADULT RETREAT APPLICATION
August 23 - 25, 2012
Name: __________________________________________________________
Address:___________________________________________________________________
City: ______________________________________ State: _________ Zip: _____________
Home Phone: ________________ Cell Phone: _______________ Other: _______________
Email address: ______________________________________________________________
Emergency Notification: ____________________________ Phone #: __________________
Doctor: _____________________ Phone: _______________ Insurance: ________________
Any allergies or medical issues that need to be addressed?
______________________________________________________________________________________________________
______________________________________________________________________________________________________
Riding Level
(please circle to your best knowledge)
Beginner: First timer or limited riding experience.
Novice: Can ride a gentle horse at a walk & trot independently.
Intermediate: Can control the horse at a walk/trot and has cantered/loped before.
Advanced: Can control the horse at a walk, trot, and canter/lope.
Tuition:
Adult Retreat, August 23 - 25, 2012
(5:00pm - 9:00pm Thurs - Fri; 10 am – 2 pm Saturday) $175.00
(also includes t-shirt, good food and a complimentary private lesson to be scheduled during the summer)
Mail to:
OPPH
P.O. Box 1239
Carlsborg, WA 98324
Phone (360) 775-5084
Please make checks payable to Sara Richerts and mail to above address with camp paperwork.
*Full payment and all camp forms are due on or before the first day of camp*
2012 ADULT RETREAT APPLICATION
August 23 - 25, 2012
Name: __________________________________________________________
Address:___________________________________________________________________
City: ______________________________________ State: _________ Zip: _____________
Home Phone: ________________ Cell Phone: _______________ Other: _______________
Email address: ______________________________________________________________
Emergency Notification: ____________________________ Phone #: __________________
Doctor: _____________________ Phone: _______________ Insurance: ________________
Any allergies or medical issues that need to be addressed?
______________________________________________________________________________________________________
______________________________________________________________________________________________________
Riding Level
(please circle to your best knowledge)
Beginner: First timer or limited riding experience.
Novice: Can ride a gentle horse at a walk & trot independently.
Intermediate: Can control the horse at a walk/trot and has cantered/loped before.
Advanced: Can control the horse at a walk, trot, and canter/lope.
Tuition:
Adult Retreat, August 23 - 25, 2012
(5:00pm - 9:00pm Thurs - Fri; 10 am – 2 pm Saturday) $175.00
(also includes t-shirt, good food and a complimentary private lesson to be scheduled during the summer)
Mail to:
OPPH
P.O. Box 1239
Carlsborg, WA 98324
Phone (360) 775-5084
Please make checks payable to Sara Richerts and mail to above address with camp paperwork.
*Full payment and all camp forms are due on or before the first day of camp*
