Camper Name *

First Name

Last Name

Camper Date of Birth *

MM

DD

YYYY

Camper's Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Camper's Previous Riding Experience *

None- I may have had a pony ride but never steered independently

Beginner- I have ridden before & know how to steer independently

Intermediate- I can steer independently & working on posting and/or gaiting

Advanced- I can steer independently, I know the correct diagonals, I can trot/ gait & cantered, I can catch/ groom/ tack my horse independently

Does the camper currently take regular riding lessons? *

Yes

No

How did you hear about us? *

Facebook/ Social Media

Google search

Existing riding lesson student

Attended a birthday party at the farm

Attended camp in the past

Family/friend

Camp Session Selection *

Week 1: June 17-20 Farm Camp (Tuesday-Friday) for ages 6-10 yrs 9AM-3PM $450

Week 2: June 24-27 Preschool Summer Camp (Tuesday- Friday) for ages 3-5 yrs (must be independent in the bathroom) 9AM-12PM $250

Week 3: July 8-11 Preschool Summer Camp (Tuesday- Friday) for ages 3-5 yrs (must be independent in the bathroom) 9AM-12PM $250

Week 4: July 15-18 Farm Camp (Tuesday-Friday) for ages 6-10yrs 9AM-3PM $450

Week 5: July 22-25 Tween Summer Camp (Tuesday-Friday) for ages 10-13yrs 9AM-3PM $550

Week 6: August 5-8 Teen Summer Camp (Tuesday-Friday) for ages 13-18yrs 9AM-3PM $550

Emergency Contact *

First Name

Last Name

Emergency Contact Phone *

(###)

###

####

In the event emergency medical aide/ treatment is required due to illness or injury during the process of receiving services, or while being on the property of Fun-E Farm T.O.O., I authorize Fun-E Farm T.O.O. to secure and retain medical treatment and transportation if needed. I release participant records upon request to the authorized individual or agency involved in the medical emergency treatment at my expense. I hold Fun-E Farm T.O.O. harmless for any expenses incurred in my interests. *

I give consent

I do NOT give consent (please complete next question)

Media release for all promotional materials (including but not limited to) photographs, audio/videos, testimonials for our use on our website or Facebook/ Instagram page and/or for print. By selecting "consent" below, you are hereby authorizing the use and reproduction by Fun-E Farm T.O.O. of any and all audio/visual materials taken of me/ my child/ my ward for promotional material, education activities, website, or for anyother use for the benefit of the program. *

Consent

Deny Consent

I would like to participate in Fun-E Farm T.O.O.’s farm programs. I acknowledge the risks and potential risks of being around horses and on a farm. However, I feel that the possible benefit to myself/ my child/ my ward are greater than the risk assumed. I hereby, intending to be legally bound, for myself, my heirs and assigns, executors or administrators, waive and release forever all claims for damages against Fun-E Farm T.O.O., Fun-E Farm Inc., FEF LLC, its owners, instructors, therapists, consultants, volunteers and/or employees for any and all injuries and/or losses I/ my child/ my ward may sustain while participating in Fun-E Farm T.O.O.’s programs. *

Yes, I agree & give consent for myself/ my child/ my ward

At Fun-E Farm T.O.O. we strive for an atmosphere of peace, courtesy, kindness and respect. Children and adults alike are treated with respect. Children will be shown how to work through conflict using communication, taking personal responsibility and offering empathy. Clear ground rules will be established so that children know the expectations for their behavior. Camp Staff will model grace, courtesy, respect, and problem solving skills throughout their daily activities. Violence or bullying will not be tolerated. Bullying is defined as repeated acts by one or more students causing harm to another. Acts may be written, verbal, physical, or any combination thereof. Bullying is ongoing by nature and is a conscious desire to hurt, embarrass, exclude or upset another. Campers may be asked to leave camp, without a refund, if they violate this policy. *

I understand this policy

We offer ice pops throughout the day to keep the kids cool & hydrated. Please confirm that your child is allowed to have ice-pops. *

Yes, my child may have ice-pops

No, my child may NOT have ice pops & I will provide an alternative for my child.