Beginning Horsemanship, June 25-29, 2012
                                        Wild West Camp, July 9–13, 2012
                                              Advanced Horsemanship, August 27-September 1, 2012

Parent or Guardian: __________________________________________________________

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? 

__________________________________________________________________________________________________

__________________________________________________________________________________________________


            CAMPER INFORMATION (Ages 5-17)

Campers Name                                              Gender    Age          D.O.B.       School Grade

______________________________________               M F    _____      ____________     ______

 ______________________________________              M F    _____      ____________     ______

                 CAMPERS RIDING LEVEL:

Previous camper at OPPH?                         YES     NO

If no, has your child attended any other riding camps (please list)?

__________________________________________________________________________

__________________________________________________________________________

                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 FEES:

______  Beginning Horsemanship,  June 25-29, 2012
            (9:00am - 12pm M – TH;  9 am – 4 pm Friday)         $350.00/WEEK*

______  Wild West Camp,  July 9–13, 2012
            (9:00am - 12pm M – TH;  9 am – 4 pm Friday)          $350.00/WEEK*

______  Advanced Horsemanship,  August 27-September 1, 2012
            (9:00am - 12pm M – F;  10 am – 2 pm Saturday)        $350.00/WEEK* 

*Price includes t-shirt, craft supplies, snack and a complimentary private lesson to be scheduled during the summer

                Extended Care
  offered by request (7:30am to 5:30pm) at $10 per extra hour

Will you need extended care?               YES     NO

If so, what times/days? __________________________________________________________

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*