2009 Summer Camp Registration

Childs Name:

Age: 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Other

Birthday: month JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 year 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996

Riding Experience: refer to definitions for proper selection No Experience Beginner Intermediate Advanced

Rider is proficient at:

Rider needs work on:

T-shirt size: (select one) Small Medium Large X-Large

Payment: (please select one)

I am enclosing a check to cover total amount due ($350 day/$495 Full)

I am enclosing my non-refundable $100 deposit for each camp I am registering for. Please hold the above session(s) for my child. I will submit the remainder due before the appropriate deadline (June 8).

I have worked out payment plans with you and am enclosing my first payment of and will be making payments for two three months.

I am registering after the deadline of June 8. I am enclosing a check to cover the total amount due + late fee ($400 day/ $545 full)

Additional Comments:

Parents Signature: ____________________________________ Date: ____________________

Necessary Phone Numbers:

Download the release form and complete.

*** Please remember to do the following ***

• Print and sign the registration form and release form
• Enclose a check made payable to John Goda III in the correct amount
• Make sure a copy of insurance card accompanies these forms
• Mail necessary forms to: IDF Camp, 2061 Fish Creek Rd., Cedartown, GA 30125
• Get ready for your child to have the time of their life.