2019 Bittersweet Summer Camp Registration

At the end of this form your deposit of $50 is required
How Did You Hear About Us?
Student Contact Information
Student's Name*
First Last
Address*
Street Address City State / Province / Region ZIP / Postal Code
Email Address*
Parental Contact Information
Parent #1
Parent #1 Name*
First Last
Parent #1 Email*
Parent #1 Cellphone*
Parent #1 Work Phone
Parent #1 Landline
Parent #2
Parent #2 Name
First Last
Parent #2 Email
Parent #2 Cellphone
Parent #2 Work Phone
Parent #2 Landline
If neither parent can be reached by telephone, please give us an alternate contact.
Alternate Contact Name*
First Last
Alternate Contact Phone*
Relationship*
Bittersweet Pet Resort & Stables has permission to release medical information to this other contact*
- Yes
- No
Please Note: Horseback Riding requires concentration and the ability to follow instructions. If your student utilizes ADHD medications, please give them this during the week of camp for safety.
Does your camper have allergies or other health conditions we need to be aware of?*
- Yes
- No
If yes, please explain.
Session Details
Beginner Riding Camp: $200.00 Intermediate Riding Camp: $275.00 Adult Horse Camp: $120 per day or discounted to only $300 for the entire weekend.
Sessions(s) to attend*
Hold down the shift key to select more than 1 choice.
T-Shirt Size*
Select Payment Option*
A nonrefundable deposit of $50 is required for each week of summer horse camp your student will attend. Your camp space is not confirmed until your deposit is made. The balance is due the first day of camp. If you need to cancel camp, we will transfer your deposit to another summer horse camp date as long as spaces are still available. We can also exchange the deposit for three horseback riding lessons which must be taken within 60 days of the start date of the summer horse camp you originally enrolled in. Please note cash refunds are not given.
1. Liability release form signed by both parents, or appropriate legal guardian or parent with sole custody. Students will not be able to ride without this form being given to the instructors at the beginning of the first day of camp. Please check one of the following boxes for your camper so we know we have the proper signatures for permission to ride:
Liability Release Form*
- Single Parent Full Custody
- Guardian
- Two Parents That Have Custody
2. Notarized Medical Release
3. Balance due for camp. (unless you paid in full on registration) Payment can be made via check or credit card whichever is convenient.
4. Sunscreen needs to be applied. Heeled shoes and long pants need to be worn.
5. We provide drinks of bottled water throughout the camp. To cut down on waste and help the environment you are encouraged to bring your own container from home. Please pack a lunch for the intermediate camp.
I have read and agree to the above terms and conditions.*
- I accept the above terms and conditions
Signature*
Email
This field is for validation purposes and should be left unchanged.

(269) 684-7361

2019 Bittersweet Summer Camp Registration

2019 Bittersweet Summer Camp Registration

At the end of this form your deposit of $50 is required

Student Contact Information

Parental Contact Information

Parent #1

Parent #2

If neither parent can be reached by telephone, please give us an alternate contact.

Please Note: Horseback Riding requires concentration and the ability to follow instructions. If your student utilizes ADHD medications, please give them this during the week of camp for safety.

Session Details

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Contact Information

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