2000 EQUILIBRIUM SUMMER HORSE RIDING CAMP
                    Full-day (8-4): $300.00/week*
                  FULL PAYMENT REQUIRED IN ADVANCE


CAMPER NAME: ___________________________________   AGE: _______


ADDRESS: ______________________________________________________


CITY: ________________________________  STATE/ZIP: ____________


PHONE: (_______)_______________________________________________


PARENT(S): ____________________________________________________


ADDRESS: ______________________________________________________


CITY: ________________________________  STATE/ZIP: ____________


HOME PHONE: (_______)__________________________________________


WORK PHONE: (_______)__________________________________________


EMERGENCY CONTACT: ____________________________________________


PHONE: (_______)_______________________________________________


RELATIONSHIP: _________________________________________________


 Select All Sessions You Wish to Attend.


 ______ Jun 12 - 16   ______ Jun 19 - 23   ______ Jun 26 - 30

 ______ Jul 3 -  7    ______ Jul 10 - 14   ______ Jul 17 - 21

 ______ Jul 24 - 28   ______ Jul 31 -Aug 4 ______ Aug 7 - 11

 ______ Aug 14 - 18   ______ Aug 21 - 25   ______ Aug 30 - Sep 1




               Day Camp Rider Information Sheet

      Please provide the following information so we may
        best match you with one of our horses.  Thanks.


Personal Information

Name: _______________________________________________________


Age: ________________________________________________________


Height: _____________________________________________________


Weight: _____________________________________________________


Allergies: __________________________________________________


Medications: ________________________________________________


Medical/Physical Issues: ____________________________________

_____________________________________________________________


< Previous Riding Information >
 (Please check all that apply)


I have never riden a horse. (yes/no) _______

I have riden for ______ years, ______ months.

I ride ______ times a week.

I can walk _______, trot _______, canter _______

I can jump crossrails _______

I can jump fences of _______ feet in height.

I have done trail riding. (yes/no) _______

I have done Horse Shows (y/n) _______, Events (y/n) _______,

       and Dressage (yes/no) _______

I own a horse. (yes/no) _______

Tell us your riding goals: __________________________________

_____________________________________________________________


Horse Request:_______________________________________________



  * Camp closes daily at 4:00 pm.
    There is a $10/day fee for pickup after 4:15 pm