SHEA-ROSE FARM

REGISTRATION FORM FOR CAMPS

 

Name:______________________________________________Age:___________

 

Address:________________________________________________________________

 

Phone:______________ Work Phone:______________ Cell Phone:____________________

 

Email Address: __________________________________________________________

 

Parent’s Names:__________________________________________________________

 

Describe Previous Riding Experience:_________________________________________

 

________________________________________________________________________

 

 

 

List Session Numbers you wish to attend:____________________





 

Pre-registration fee: $100.00 per rider per week (non-refundable, to be subtracted from remainder of clinic fee due on the first day of clinic).

 

Registration fee enclosed? ____________

 

Hold Harmless form with both parent’s signature enclosed? (if not already on file)______

 

Students are required to wear SEI/ASTM approved helmets, pants, shirts with short sleeves and boots with a small heel while riding.

 

Send form with payment [check made out to: SHEA-ROSE FARM, Inc.]

 

Carol Land

Shea-Rose Farm

2411 Waxhaw Marvin Road

Waxhaw, NC 28173

 

Any questions please email at shearose@mindspring.com. Visit us on the web at: www.shearosevaulters.org or www.shearosefarm.com.