2014 Young Rider Camps

Venue:
22761 Evergreen Mills Road
Leesburg, VA 20175
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INFO:   Please note that this form contains limited capacity items which are sold out. They are displayed grayed out and are not selectable.



Direct any inquiries to the following:

Nancy Smith
703-723-3200
nancy@twinoaksriding.com

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Membership
Unless otherwise indicated, the information below should be completed with the Camper's details. (First Name, Last Name, etc). There will be space provided for the Parent's or Guardians of the camper to include their contact info.
First Name
Last Name
Email
Age
Address
City
State
Zip
School
Grade or Troop Number (If your child is coming with a troop, please include the troop number so they can be grouped together)
Phone
Mom's Name and Work/Cell Phone
Dad's Name and Work/Cell Phone
Terms
Release of Liability, State of Virginia, County of Loudoun
I (we) the undersigned student, parent, or legal guardian of a student of the Twin Oaks Riding Academy (hereinafter referred to as “Twin Oaks”), for and in consideration of my child, or a
student for whom I have been granted legal custody, hereby voluntarily and knowingly execute this Release with the express intention of effecting the extinguishments of, and complete
release from any and all claims, actions, demands or rights to monetary judgment arising from any and all injury or physical or emotional or mental harm which may arise from or be
sustained as a result of my participation or the participation of my child and/or legal ward, in the various programs of instruction, practice, clinics, open riding, camps and physical activity or
from observing the activities associated with the study of English riding or horsemanship and related activities conducted by Twin Oaks and its owners and any of Twin Oaks’ employees. I
hereby agree to hold Twin Oaks Riding Academy, Nancy Smith, Twin Oaks owners and employees, and Cavallo Farm, its employees and owners, Michael and Marie Bertozzi, free from
all damages or liability for any injury to the person or property arising out of the use of horses or equipment while riding at Twin Oaks or while attending or observing any horse shows,
clinics, camps, or while performing chores, whether voluntarily or for compensation, or other horse related activities while on the premises of Twin Oaks Riding Academy or while away
from Twin Oaks Riding Academy.
I agree to wear a regulation ASTM approved hard hat (helmet) at all times while mounted on a horse. I agree to assure that my minor child will wear a regulation ASTM approved hard hat
(helmet) at all times while mounted on a horse.
I understand that the Twin Oaks Riding Academy and its employees make no warranty as to Twin Oaks or its employees, contractors and instructors’ ability to provide training or other
protection against riding related accidents, injuries, including repetitive stress injuries, emotional distress or death as a result of participation at Twin Oaks.
I recognize that riding a horse is a dangerous sport and I acknowledge that I have read and understand the foregoing warnings and disclosures.
This waiver gives notice to the participant of the risks inherent in equine activities, including (i) the propensity of an equine to behave in dangerous ways which may result in injury to the
participant; (ii) the inability to predict an equine's reaction to sound, movement, persons, or animals; and (iii) hazards of surface or subsurface conditions.
Check this box to indicate that you have read and agree to all of the above terms & conditions
Type your name to confirm with Electronic Signature

Emergency Contact Information (If neither parent can be reached)
Name
Telephone Number
Relationship to Rider
Preferred Doctor/Telephone
Preferred Hospital/Telephone
Medical Information: Please any and all physical handicaps, emotional or physical problems, chronic ailments or allergies, including any medications associated with disorders affecting attention span, and/or behavior, alertness or motor skills.
List medical information, if any. If none, please list "none".

Camp Selection:  Please select all that you would like to attend.


Saturday Young Rider Camp (Ages 5-12) 1-3 p.m.
$ 45
Please select all dates that you would like to attend: Feb. 22 2014
March 15 2014 FULL
March 22 2014 FULL
April 5 2014 FULL
April 26 2014 FULL
May10 2014 FULL
May 17 2014 FULL
June 7 2014 FULL
June 14 2014 FULL

Spring Break Young Rider Camp (Ages 5-12) 9-11 a.m.

Please check the box if you would like to attend Spring Break Camp Spring Break Camp April 14-18 2014 9-11 a.m.

Lunch with Horses: Campers stay until noon and feed the horses their lunch , eat their own lunch (you provide) and participate in other horse activities. Cost: $99
This is available for Spring Break Camp..

Would you like to attend Lunch with Horses at the Spring Break Camp for$99.00? Yes

Summer Young Rider Camp (Ages 5-14) 9-11 a.m.

Please select all dates that you would like to attend: June 16-20
June 23-27
June 30-July 4
July 7-11
July 14-18
July 21-25
July 28-August 1
August 4-8
August 11-15
August 18-22
August 25-29

Lunch with Horses: Campers stay until noon and feed the horses their lunch , eat their own lunch (you provide) and participate in other horse activities. Cost: $99
 

Would you like to attend Lunch with Horses for $99 ? June 16-20
June 23-27
June 30-July 4
July 7-11
July 14-18
July 21-25
July 28-August 1
August 4-8
August 11-15
August 18-22
August 25-29


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