Camp Registration

Horse Sense Summer Camp General Information

1. Child's First Name
2. Child's Last Name
3. Address
4. City
5. Province
6. Postal Code
7. Date of Birth (yyyy-mm-dd)-please use format
8. Age at Time of Camp
9. Gender
   1. Male
   2. Female
10. Parent/Guardian Name(s)
11. Home Phone
12. Work Phone
13. Cell Phone
14. E-Mail
15. Alternative Emergency Contact Name
16. Relationship to Participant
17. Home Phone
18. Work Phone
19. Cell Phone

Medical History and Information

1. Participant's Alberta Health Care Number
2. Family Doctors' Name
3. Is the student up to date on immunization shots (including tetanus)?
   1. Yes
   2. No
4. Allergies or Health Concerns
5. Is the student required to take any medications while at camp? If yes, please explain: PLEASE NOTE: ANY MEDICATIONS YOU ARE SENDING WITH YOUR CHILD, WHETHER PRESCRIPTION OR NON-PRESCRIPTION (TYLENOL), MUST BE ACCOMPANIED BY A LETTER OF PERMISSION FOR GRIFFIN VALLEY RANCH STAFF TO ADMINISTER WHEN NEEDED.
6. Please list any disabilities your child may have
7. Can the student participate in all physical activities?
8. Other important information

Additional Information

1. Participants experience with horses: (Griffin Valley Ranch Staff will place your child in a group they deem to be the most appropriate)
   1. never rode
   2. 1 to 5 rides
   3. 6 to 10 rides
   4. 10 rides plus
2. Where did you hear about our camp or ranch?
   1. Google/Firefox/Internet Explorer
   2. Calgary's Child magazine
   3. Calgary Herald
   4. Calgary Sun
   5. Calgaryarea.com
   6. Bizcalgary.com
   7. MySummerCamps.com
   8. Word of Mouth

Optional Lunch Program

Choose one of the following for each day: (Juice/beverage accompanies each choice)

1. Monday Lunch Options --- Please Select --- Hot Dog & Fries (all beef) Chicken Fingers & Fries (includes plum sauce) Taco in a bag (Doritos chips, seasoned hamburger, lettuce, shredded cheese, salsa and sour cream) Veggie Sub (lettuce, tomatoes, cucumber, cheese, mayo, butter) & Chips
2. Tuesday Lunch Options --- Please Select --- Taco in a bag (Doritos chips, seasoned hamburger, lettuce, shredded cheese, salsa and sour cream) Hot Dog & Fries (all beef) Chicken Fingers & Fries (includes plum sauce) Veggie Sub (lettuce, tomatoes, cucumber, cheese, mayo, butter) & Chips
3. Wednesday Lunch Options --- Please Select --- Taco in a bag (Doritos chips, seasoned hamburger, lettuce, shredded cheese, salsa and sour cream) Hot Dog & Fries (all beef) Chicken Fingers & Fries (includes plum sauce) Veggie Sub (lettuce, tomatoes, cucumber, cheese, mayo, butter) & Chips
4. Thursday Lunch Options --- Please Select --- Taco in a bag (Doritos chips, seasoned hamburger, lettuce, shredded cheese, salsa and sour cream) Hot Dog & Fries (all beef) Chicken Fingers & Fries (includes plum sauce) Veggie Sub (lettuce, tomatoes, cucumber, cheese, mayo, butter) & Chips
5. Friday Lunch Options --- Please Select --- Taco in a bag (Doritos chips, seasoned hamburger, lettuce, shredded cheese, salsa and sour cream) Hot Dog & Fries (all beef) Chicken Fingers & Fries (includes plum sauce) Veggie Sub (lettuce, tomatoes, cucumber, cheese, mayo, butter) & Chips

Griffin Valley Ranch Safety Equipment & Apparel

1. Equipment/Apparel
   1. Youth T-Shirt w/ ranch logo $15.00
   2. Youth Long Sleeve T-Shirt w/ ranch logo $20.00
   3. Youth Hooded Sweatshirt w/ ranch logo $30.00
   4. International Riding Helmet Equi-Lite (Dial Fit System) $50.00 (staff will fit and size your child appropriately)

Session Dates & Pick up Locations

1. Please select a camp session date
   1. Session 1: July 2 - July 6
   2. Session 1A: July 3 - July 6 (4 day camp)
   3. Session 2: July 9 - July 13
   4. Session 3: July 16 - July 20
   5. Session 4: July 23 - July 27
   6. Session 5: July 30 - August 3
   7. Session 6: August 6 - August 10
   8. Session 6A: August 7 - August 10 (4 day camp)
   9. Session 7: August 13 - August 17
   10. Session 8: August 20 - August 24
   11. Session 9: August 27 - August 31
2. PICK UP POINT (Please note: If your child is riding the bus, the person that drops the child off on the first day of camp must check in with the leader taking attendance. We must receive the 'WAIVER OF CLAIMS AND INDEMNITY AGREEMENT' and 'ENROLLMENT AGREEMENT' before the child boards the bus)
   1. Bearspaw Gas Station
   2. Cochrane Ranche Parking Lot
   3. NW (Foothills Swimming Pool)
   4. SE (Fish Creek Library)
   5. SW (Bishop Carroll High School)

Payment Options

Please select the appropriate box(es) indicating which camp fees you would like to pay with registration. You must pay the non-refundable deposit fee with registration unless you choose to pay the full camp fee at this time. The remainder of fees must be paid on or before June 1st 2012.

1. 5 Day Camp Fees ($525.00 including GST)
   1. 1
2. 5 Day Camp Lunch Fees ($47.25 including GST)
   1. 1
3. 4 Day Camp Fees ($420.00 including GST) ***Sessions 1A and 6A only***
   1. 1
4. 4 Day Lunch Camp Fees ($37.80 including GST) ***Sessions 1A and 6A only***
   1. 1
5. Youth T-Shirt w/ ranch logo ($15.75 including GST)
   1. 1
6. Youth Long Sleeve T-Shirt w/ ranch logo ($21.00 including GST)
   1. 1
7. Youth Hooded Sweatshirt w/ ranch logo ($31.50 including GST)
   1. 1
8. International Riding Helmet Equi-Lite (Dial Fit System) ($52.50 including GST)
   1. 1
9. Non-Refundable Deposit ($157.50 including GST)
   1. 1