www.caseysplace.org
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Free 2B Me Summer Camp
>
Registration Summer Camp
Parental Authorization and Release Form
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Riding School
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Registration Riding School
Parental Authorization and Release Form
Registration for Riding School
*
Indicates required field
Student's Name
*
First
Last
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Mother's Name
*
First
Last
Mother's Cellphone Number
*
Mother's Workphone Number
*
Father's Name
*
First
Last
Father's Cellphone Number
*
Preferred Email
*
Father's Workphone Number
*
Cost is $35 per 1 hour lesson
Payments are paid in cash or check
Contact me on following number:
*
Mother's Cellphone
Mother's Workphone
Father's Cellphone
Father's Workphone
Email
On first day of class, remember to bring the following
*
Liability Waivers signed by both parents (Students will not be allowed to ride if we do not have these completed documents)
Sunscreen applied in advance of class (if applicable)
Please check all three boxes for ackgnowledgement
Submit
