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Horse Camp Registration

Basic Camper Information

First Name
Last Name
Month
/
Day
/
Year

Parent/Guardian Information

First Name *
Last Name *
Country
Address Line 1
City
State/Province
Postal Code
Preferred method of communication

Medical & Safety Information

Permission to administer basic first aid
Permission to call 911 in case of emergency

Horse Experience

Has your child ridden before?

Media Release & Waivers

Please download and return this general release and liability waiver to knelson@horseshelpswi.org

Registration Dates and Payment

Horse Camp Registration Dates
Select payment to complete registration
Credit Card Information
Visa MasterCard American Express Discover

Visa®, MasterCard® & Discover® cardholders
Your security code is the 3-digit code at the end of the signature field on your card's back.

American Express® cardholders
Your security code is the 4-digit code located above the actual credit card number on your card's front.

Cover the fee associated with this online transaction?
Cover the fee associated with this online transaction?
Your total payment will be .
Your credit balance will cover
Your credit card will be charged
Your bank account will be charged

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