Circle-T-Ranch   2011      Summer  Day  Camp

                                                  619-312-0544     13250 Willow Rd, Lakeside, CA 92040          www.thecircletranch.com

Camp Registration Form -  print out,    (mail  with deposit of 50 % )

Camper Name: _____________________________         Age__________        Registration  Date:  ____________

Camper Name: _____________________________          Age__________

Address______________________________________________________         Full or Half day    _____________

City State and Zip______________________________________________

Parent 1 Name________________________________

                      Home phone_____________________       Work  _______________             Cell    ____________

Parent 2 Name________________________________

                      Home phone_____________________       Work   _______________             Cell   ____________

Alternate Emergency Contact Name: _____________________      Phones     _____________________________

HEALTH HISTORY:         Camper’s general health (list conditions or illnesses, allergies and medications): 

_____________________________________________________________________________________________________

                     REGISTRATION FEES 

Full Day Session: $345            However when enrolled in - - -  -    March:  discount  of   25%   =   $ 258

                                                                                                           April          "       "      20 %  =   $ 276

                                                                                                           May          "       "      15 %  =    $ 293

 Online payment available   add 5.5 % to payment              Cancellation Policy - refund with 2 weeks written notice

Session # 1      June   13  thru  17                  5     July    18  thru   22
                   2      June   20    -     24                  6      Aug     1     -      5
                   3      June   27    -    July  1               
                   4      July    11     -     15                   ( B B Q   every Friday )

Please Circle Camper’s Riding Experience:

Some  experience

No riding experience

At least 1 year of exp.

 English Rider Western Rider Trail ride only     

 Please dress in suitable attire  ( long pants, t-shirts, sneakers or boots )  for riding.   Safety helmet provided.
 Bring sunscreen, water bottle, and insect repellant.   Camera, sunglasses, and shorts are optional.   Label all items.
 Backpack required.

           Circle-T-Ranch is not responsible for lost or stolen personal belongings or equipment required to attend camp.

           There is a refrigerator for food and drinks and a microwave available in the cabin

           Referred by :   SD  Family Magazine ______ Internet/Website   _____   Mail  ______  Friend  _____

            **  I have read and signed the accompanying release of liability.**

Parent signature:   _______________________________

Printed name         _______________________________           Date signed:       ____________






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For Office Use Only

Ck. #     _____________     Cash   $  ____________         Date   ____________Session    # _____________

Deposit amt.    $  ________________            Balance due    $    _____________Signed release   _________

Remarks __________________________________________________________________