Horse Camp Registration
Circle B Stables
5815 Root Road/Spencer, OH./44275
Name of Child:__________________________________________________________
Telephone:__________________________________________ Date of Birth:________
Parent or Guardian:________________________________Daytime phone:___________
Medication, allergies, physical and/or mental disabilities:__________________________
If parents are unable to be contacted, please list two or three other persons that we can contact in case
I UNDERSTAND THAT FOR THE SAFETY OF MY CHILD AND OTHERS, THE FOLLOWING RULES WILL
BE ADHERED TO. DISRUPTIVE CHILDREN WILL BE DISMISSED FROM CAMP WITH NO REFUND.
1. RESPECT ADULT AUTHORITIES.
2. KEEP HANDS, FEET AND OTHER OBJECTS TO YOURSELF.
3. SAFETY GEAR WILL BE WORN WHEN REQUIRED.
4. REGARD FOR OTHERS IN MANNER AND SPEECH WILL BE POLITE AND COURTEOUS.
I understand that the fee is $275, a deposit of $125 payable with registration and the remainder $150
upon arrival at camp.
*I give permission to Circle B Stables to care for my child for the week of _________
_________ and understand that my child will be participating in swimming and hiking, and activities
involving horses which will include but may not be limited to: basic horsemanship, leather care; grooming,
tacking up and trail riding.
I have read and understand the Ohio Equine Statute 2305.321, and I have read, signed
and fully understand the Circle B Stables release and waiver.