2023Pony Camp Registration Form

Students Name *

First Name

Last Name

Parent / Guardian Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Emergency Contact

First Name

Last Name

Emergency Contact Phone

(###)

###

####

*

Please check desired sessions /session. *Note: A two week minimum is required to maximize learning experience (need not be consecutive.)

Week1: 06/20/23 to 06/23/23

Week2: 06/27/23 to 06/30/23

Week 3: 07/04/23 to 07/07/23

Week 4: 07/11/23 to 07/14/23

Week 5: 07/18/23to 07/21/23

Week 6: 07/25/23to 07/28/23

Week 7: 08/01/23 to 08/04/23

Week 8: 08/08/23 to 08/11/23

Week 9: 08/15/23 to 08/18/23

Week 10: 08/22/23 to 08/25/23

AM Program

PM Program

AM Program + Extended hrs