Haverhill Farm Camp Application

Camper’s Name ______Camper’s Age______

Please circle camp session(s) of choice: June 19-23July 10-14

July 24th-28thAug 14-18

Parent’s Name______

Home Address______

Home Phone______Cell Phone______

Work Phone______Cell Phone______

Best Number to call ______

Email Address______

Emergency contact if parents cannot be reached______

In the event a parent cannot be reached in case of emergency, Carol Straus, Jessica StrausBoppe, Natalie Shinnamon, Libby White, and/or any staff member have permission to call emergency services and transport to the nearest medical facility.

Parent Signature______Date______

Insurance Company Name and ID#______

Insured’s Name______

Please list any conditions or allergies of the camper ______

Do we have permission to photograph/video and use any photos for advertising or educational purposes?______

How did you hear about Haverhill Farm?______

Riding experience:______

Camp deposit is non-refundable. Non-refundable camp payment in full is due upon arrival for the first day of camp. If in the opinion of management, camper is considered a risk to themselves, others, or the animals, parent agrees to remove camper from camp and hold Haverhill Farm and its management and staff harmless.

Parent Signature______Date______

Summer Camps

Summer camp includes a daily lesson for each camper. Also included are barn activities, horsemanship skill and theory lessons, guest speakers, arts and crafts, and FUN!

Summer camp hours:

9:00AM-4:00 PM Monday-Friday

Campers are to be dropped off at 9:00 and picked up no later than 4:00.

Early drop-off or late pick-up is available at $10/hour

Summer Camp Fees:

Camp is $450 week for full day and $385 for half day.

$35 fee for registration not received the Monday prior to camp. $25 discount for early registration (by June 1) bringing a friend, or signing up for multiple weeks!

Campers applying for the full week of camp will be given first available spots, daily campers will be permitted if space allows at $100/day.

2017 Camp Dates

June 19-23

July 10-14

July 24th-28th

Aug 14-18

Camp fills quickly and reservations are required.

A $100 non-refundable deposit is required with applications. Applications, waiver of liability, and deposit MUST be received 1 week prior to the first day of camp.

Payment Notes

All checks are made payable to Haverhill Farm and can be mailed along with application and waiver of liability to:

Haverhill Farm

1356 Hockett Road

Manakin Sabot, Virginia 23103

Payment less the deposit for the full week is due at drop-off on the first day of camp. If attending for a partial week, full payment less the deposit is due the first morning of attendance.

Early drop-off or late pick-up is available.

Camp Notes

Campers are to provide their own lunch daily.

●Camp is held rain or shine, we have a covered arena for shade and shelter!

●Please bring water to drink, juice attracts insects. Refill water is available, bottled water is $1.00.

●Sunscreen should be applied prior to arrival and brought with campers to re-apply during the day.

●Long pants—no capris, no shorts—are required for riding. Leggings, tights or jeans are acceptable.

●A change of clothes for afternoon activities is advisable.

●Paddock boots or closed shoes with a hard sole and heel are required.

●Riders should have their own helmets, please let us know if you’ll need to borrow. Long hair should be in a pony tail so a helmet can fit comfortably.

●No jewelry please.