2017-18 Twin Oaks Camps

40788 Red Hill Rd
Leesburg, VA 20175
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Registrant Fee: $0.00



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Billing and Payment
Billing and payment processing for Businesses' events is performed by Member Solutions, Inc. ("MSI"), and this contract is specifically assigned to MSI for all such purposes. Customer knowingly and irrevocably authorizes MSI to charge electronically Customer's bank account and/or credit card for any and all amounts due for Customer's, and anyone registering under Customer's, attendance and participation in the Event. Please note, you may see all or any portion of the following on your bank or credit card statement: "MSI*TWINOAKSRIDINGACADEM 8882448044 ONLINE REG FEE". Any returned payment will be assessed a $25.00 fee. Any unsuccessful electronic transaction is subject to a $10.00 processing fee. MSI is not responsible for any bank fees incurred by Customer. MSI has the sole right to resubmit returned or declined items (plus applicable fees) without prior notice. BILLING INQUIRIES -- 888-244-8044 or by mail to PO Box 297, Hatboro, PA 19040.

Applicant Agreement
I represent that I am the person who appears on the application above. I acknowledge and agree to the statements, terms and conditions above, as well as any applicable terms and conditions for this registration, and that by typing my name below and completing this registration form, I am electronically signing the document, which will have the same legal effect as the execution of the document by a written signature and shall be valid evidence of my intent and agreement to be bound.

Applicant Signature
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Registration inquiries:
Mackenzie Parks
703-459-8216
twinoaksriding@gmail.com
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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.
I understand that there are no full or partial refunds once my enrollment is complete.

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, Mackenzie Dickson Parks, Twin Oaks owners and employees, and Dancing Horse Equestrian Center, its employees and owner, Abby Khan, 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

Emergency Contact Information (If neither parent can be reached)
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.

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


Saturday Young Rider Camp
$45

December 2nd, 2:30 - 4:30
December 16th, 2:30 - 4:30
January 6th, 2:30 - 4:30 (Bad weather date: January 13th)
February 10th, 2:30 - 4:30 (Bad weather date: February 17th)