www.zionfarms.com

OFFICE USE ONLY   PAID: Check #________________________  Credit Card _______________________   Amount: _______________________   Balance Due: _________________________   Mailed Receipt and Forms: Yes    or   No   Date   mailed:________________________

ZION FARM’S HOLIDAY CAMP 2005

Cost: Overnight $650
$18.00 long sleeve t-shirt will be added to the store accounts

Registration Form
Payment must be made in full with registration.

Camp Session Dates: Dec. 26th -30th OVERNIGHT CAMP, Girls & Boys ages 8-12

Level (circle one):
Beginner- Riders that have little or no experience to riders who are working on the posting trot.
Intermediate- Confident and in control posting, working on a canter and may have started cross rails.
Advanced- Confident and in control at the trot and canter, and can jump a course of at least 4 fences.

Circle: Female or Male

Name: ________________________ Age: _____ School: ___________________________
Address: ____________________________City: ____________State: _____Zip:________
Phone: ________________ Parent’s Name: _____________________________________
Email address ____________________________________________________________
Fax # ______________________________ Work Phone: __________________

Emergency Number to call if parents cannot be reached: ________________________________________
Relation ________________ Name of person contacting ____________________________________________

Please describe your child’s riding experience:__________________________________________________
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Please describe any allergies or limitations/ medication that the Zion staff should be aware of while your child is at camp.
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Thank you for choosing Zion’s Equestrian Camp.

Payment: We take either cash, check or Credit Card.
Credit Cards: Visa or Master Card
Number: __________________________________________ Exp. Date: _________
Zip Code: ____________ Last 3 digits on back of card: ______________
Name on Credit Card: ______________________________________________________________

Mail payment to:
Zion Farms
Attn: Accounts Payable
P.O. Box 860
Armuchee, GA 30105