South Berks Pony Club

Junior Camp 2017 Booking and Indemnity Form

Monday 7th August 2017– Friday 11th August 2017 at Cullinghood Equestrian Centre Heron’s Farm, Pangbourne RG8 8QA

Camp Organisers – Beckie Burdess and Viv Armstrong

Please return forms to Viv at Stone House, Bradfield College, Reading RG7 6BQ or (07951019686)

RIDER INFORMATION

NAME
AGE (at time of event)
D.O.B.
Any special dietary requirements or allergies?
(please give details)
Any medical conditions or other issues we should be aware of?

PARENT INFORMATION

NAME
ADDRESS & Postcode
HOME PHONE NUMBER
MOBILE NUMBER
E-MAIL
Please supply the name & number of someone we could contact in the event of being unable to contact you.
NAME
CONTACT NUMBERS

Are you happy for “domestic” medication/first aid to be administered to your child by camp mum? This may include for example, plasters, paracetamol /ibuprofen, antiseptic and bite/sting ointments. Yes / No (please circle)

Should your child be on medication during his/her time at camp please hand it to camp mum with a signed slip and dosage details.

PONY INFORMATION

All ponies at Junior Camp are stabled and hay and straw is provided. If you wish to take your pony home at night or bring your own alternative bedding please indicate on the form below.

NAME OF PONY:
AGE:
HEIGHT:
COLOUR:
DATE OF CURRENT VACCINATION:
Please supply emergency contact details if your pony is staying overnight.
Contact Name:
Contact Numbers:
In case of emergency and in the absence of being able to make contact please supply your Vet’s Details. By doing so you give us permission to contact them in an emergency if we are unable to contact you or the given contact.
Vet’s Name & Practice:
Vet’s Number:
My pony requires overnight stabling? / Yes / No
My pony would like a straw bed? / Yes / No – we will bring our own alternative bedding
Is there anything else we should know about your ponies likes/ dislikes / habits?

·  Ponies must have a current Equine Flu vaccination to attend camp.

·  Please ensure ponies are wormed at least a week before camp.

We will contact you nearer the time to find out more about what you and your pony have been up to, to help us with grouping.

Rules and Provisions to be agreed and accepted by parents, guardians and children for SBPC Junior Camp 2017

No responsibility can be accepted for pony, tack and personal belongings of any child at camp.

The committee, camp organisers, instructors and others responsible for the running of camp (“the organisers”) will endeavor to ensure the well being of any child at camp but cannot be responsible therefore.

All children must accept and abide by directions and instructions given by those responsible for the running of camp.

If the behaviour of a child at camp is such that the organisers feel they may not continue at camp then upon notification of this the parent/guardian must remove the child and pony immediately. The organisers reserve the right to return the child and pony if this collection is not effected promptly.

There will be no refund of fees once a child has been registered for camp.

If in the opinion of the organisers, a pony attending camp is in such a condition that it cannot be expected to complete camp without injury or hardship to itself or the child, the pony will be required to leave. Please ensure that your pony is fit and well.

In the event of accident or injury, the organisers are authorised to take whatever steps are felt appropriate to secure the well being of the child and pony. The parent/guardian would be responsible for the fees necessarily incurred. In the event of emergency parents/guardians will be contacted.

______

I have paid the deposit of £100….Via the on-line booking system / by bank transfer / by cheque (made payable to South Berks Pony Club) (Please circle)

Final payment of £160 to be received no later than July 24th please.

Payment Instructions for bank transfer

Please use the reference J Camp17 followed by your surname. Account sort code 40-52-40, account number 00024275 CAF BANK.

Please email Liz Reed and Viv to confirm when you have made this payment.

Please feel free to pay the full amount at anytime prior to the deadline.

Print Name______

Parent/Guardian

Signed:………………………………………………………..Date:……………………………………………