Test Page for Gravity Forms Error 2 Int-Adv Enrollment 2022 - Test Step 1 of 9 - Overnight Camp Enrollment Form 11% I am enrolling for Intermediate- Int-Advance July* Yes No different week We have a very limited space in our level of Intermediate to Advance Camp. Students must be currently taking monthly lessons and or currently riding at Intermediate-Advance to Advance level.For other weeks please check the page site for that camp.This page is only for Intermediate- Int.-Advance July For all other weeks please check the page site. HiddenEnrollmentPassword for returning Campers needed Register as a* New Camper Returning Camper New Camper: First time student, or previous campers who did not participate in summer 2021. Returning Camper of 2021: Registration or login for students who participated in summer of 2021. Password RC* HiddenPassword New* Deposits are 1/2 tuition balance due June 15th*After June 15th Full Payment is required. I read and understand New EnrollmentTuition Fee: $985 by May 1st, after May 1st +$25 ReturningTuition Fee: $935 by May 1st, $960 by June 1st, + $25 after June 1st Return JC-YR-StudentTuition Fee: $825 by April 1st, $845 by May 1st, $875 by June 1st, + $25 after June 1st Parent/Guardian Name* First Last Cell Phone*Email* Camper's Name* First Last HiddenCamper's Shirt Size*Y-SY-MY-LA-SA-MA-LHiddenCamper's Birthday* MM slash DD slash YYYY HiddenCamper's age as of June 1st, 2021*910111213141516HiddenRiding Experiences: **Check ALL that applies* 20-40 (trot only) 20-40 hours (trot and lope on their own) 40+ hrs. Rider (trot lope on their own) Currently taking Lessons 2-4 times/month, Not taking lessons ride 3-4 times/month Check all that applies HiddenCheck Camps ridden at:* Rode at different camp before Rode at M&M Ranch last summer Not ridden camp before HiddenRiders Experience and/or at Camp:* Name of Stable Ridden at? How often take lessons? Type of riding? Name Camp Rode at? Location of Camp HiddenDescribe what rider is currently working on.* HiddenPast 6 months: Please answer following questions*1. How much riding done in last 6 months? 2. What skills is rider working on improving or need help with? Camper's grade level start of January 1st, 2021*4th5th6th7th8th9th10th11th12thCamper's height*3'8" - 3'11"4' - 4'4"4'5" - 4'7"4'8" - 4'11"5' - 5'3"5'4" - 5'7"5'8" - 6'Camper's weight*50 - 60 pounds61 - 70 pounds71 - 80 pounds81 - 90 pounds91 - 100 pounds101 - 115 pounds116 - 130 pounds130 - 150 pounds2nd Phone #Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Known Allergies* Yes No Allergies*(check all that apply): Animals Insect Stings Medications Food Hay Fever/Pollen Plants Other Other/Specify Allergies:* Known Medical Conditions that could affect camper's riding* How did you hear about us?*FriendRelativePrevious CamperCamp Advertising SiteSearch on InternetotherPerson referred you?* Which website did you hear about us?* Riding Experience* Western Barrel Competition Pole Competiton Bareback Riding Gymkhana/other speed events Walk only Trot lope/canter Capable mounting & dismounting without stirrups English/Hunt Dressage Currently Compete Trail Rides None Check all that applies Riding Experience tack & grooming, groundwork* Grooming Tacking Un-tacking Bridle several types horses Safety check with tack Capable halter/catch Know how use rope halter Safety release knot Tying horse safely Capable lunging horses safely in round pen Capable of lunging horse on lead rope None Check all that applies Please describe riders experiences*If camper uses her own horse*NoneJust started competing-not faster then trotJust started competing-not faster then lopeJust started competing-able to runCompeted 8+ times local shows in past 12 monthsDo not compete but interestedIf camper is currently using someone else's horse?*NoneJust started competing-not faster then trotJust started competing-not faster then lopeJust started competing-able to runCompeted 8+ times local shows in past 12 monthsDo not compete but interested Important Safety Information*Horseback riding is a very physical outdoor recreational activity. For camper safety and the safety of others, participants must meet certain physical requirements to attend camp at M&M Ranch. Our camp is designed for our campers to ride in groups. Campers must be in good physical shape and not have any conditions that may affect their ability to participate in all camp activities. These include but are not limited to items such as arthritis, excessive weight, back or neck pain, decreased motor skills or other physical issues that may contribute to a difficulty balancing, staying seated, holding the reins or controlling a horse. Campers must be able to mount and dismount a horse without assistance (Instructors will help younger campers). Campers must be able to meet the rigors of riding, including dismounting the horse without stirrups. Campers must have the ability to independently remain seated and balanced on a horse in motion while simultaneously directing a horse's travel and speed for at least 1-2 hours. Campers must be able to withstand summer exposure to the outdoors, including hot, cold and or wet weather for a period of at least 2 hours. For the safety of all campers, we do not offer services for special needs riders. We recommend that you visit R.O.C.K. - Ride On Center for Kids which specializes in special needs riders. We are not set up to have one on one instruction with riders who have special physical or emotional limitations. Thank You! I have read and understand the Important Safety Information on attending summer camp at M&M Ranch. Medical information Needed*We will need student's medical information. Pick if you want provide that now or after enrollment.Will provide Medical info today with EnrollmentWill provide Medical info after Enrollment Medical InformationInsurance Name* Insurance Phone #*Policy Holder's Name* First Last Relation to Camper* Group ID#* Policy ID#* Emergency Contact Name*(Other than parent listed on enrollment form) First Last Relation to Camper*GrandparentParentFriendOther RelativeEmergency Contact Phone*Illnesses & Injuries*(check all that apply) Chronic or Recurring Illness or conditions that could affect riding: Asthma Constipation Bleeding/Clotting Disorders Diabetes Ear Infection Emotional Disturbances Fainting Hearing Impairment Nosebleeds Musculoskeletal Disorders Menstrual Cramps Wears glasses or contact lens Other None Specify Other Illness or Chronic Condition:* Does your overnight camper take any medications?* Yes No Are they able to self-administer?* Yes No Medication*List any medications that the camper will need to take during camp. All medications must be in its original container and will be kept in the office during camp. Medication Name Dosage Frequency Purpose of Meds: MedicationList any medications that the camper will need to take during camp. All medications must be in its original container and will be kept in the office during camp. Medication Name Dosage Frequency Purpose of Meds: Medications allowed to be administered to my child during camp:*(check all that apply) Benadryl (allergic reactions) Allegra Evening primrose oil for menstrual cramps Boiron Chestal Honey Cough Syrup Ibuprofen Liquid Benadryl (skin allergies) Neosporin (skin irritations) Tea Tree Oil (insect bites) None Anything you feel we need to know?* HiddenAre you bringing your own horse?*NoYesBringing Your Own Horse Policy*If you are bringing your own horse, boarding fee (non-refundable) must be paid in order for registration to be complete and hold your spot. If you decide the horse you had planned to bring does not work out for some reason, it will be your responsibility to find another horse. If a horse change needs to occur please email at least 4 weeks prior, so we can send you the form for the updated change. List of Requirements: broke, well behave, healthy, at healthy weight, must be in condition to handle full week of camp. Copy of Current Coggin, Tetanus Shot Teeth floated at least within 8 months prior camp Current on feet care & recent exam for any pain. Health Certificate (within 30 days coming to the Ranch) I have read and understand requirement bringing my own horse. Boarding 1 Horse -N (We provide Hay)* 1 Week Boarding 1 week (Sunday-Friday 12 P.M.) $125 You will need bring your own feed. We do not provide tack for your horse. You will recieve a list of what to bring for your horse after you enroll. Boarding 1 Horse -R (We provide Hay)* 1 Week Boarding 1 week (Sunday-Friday 12 P.M.) $125 You will need bring your own feed. We do not provide tack for your horse. You will recieve a list of what to bring for your horse after you enroll. HiddenToday's Date MM slash DD slash YYYY Tuition includes ranch shirt, award and outings. Outings Campers will need cash for food, snacks & souvenir shopping during the field trips. (Recommend $30-$40) PaymentCampers will need bring Cash- food & snacks during the field trips. (Recommend $30-$40)Tuition includes ranch shirt and outings.Camp Registration* Price: Deposit* Full Payment Half Deposit HiddenCancellation Policy - Deposit*If for some reason, (e.g. emergency), you need to cancel your child’s camp the following conditions apply: The deposit is non-refundable. If you have an emergency and need to cancel your child’s camp session, please email us. We do not offer refunds for any reason. If you have a balance due after the posted deadline the late fee of $100 for Overnight camps will be applied. If the balance is not paid in full within 5 days of posted deadline, your child’s spot will be forfeited to the next child on the waitlist. (you will lose your reservation & deposit) Your enrollment for camp will not be complete until we receive all required forms. I have read and understand the Payment, Cancellation, Refund Policy on attending summer camp at M&M Ranch. HiddenCancellation Policy - Full*If for some reason, (e.g. emergency), you need to cancel your child’s camp the following conditions apply: Camp payment is non-refundable. If you have an emergency and need to cancel your child’s camp session, please email us. We do not offer refunds for any reason. Your enrollment for camp will not be complete until we receive all required forms. I have read and understand the Payment, Cancellation, Refund Policy on attending summer camp at M&M Ranch. Half Deposit* Price: $0.00 Process Fee* Price: $0.00 Coupon- Press Apply after enter code Total $0.00 Credit Card*Card Details Cardholder Name HiddenImportant*Submitting your enrollment may take a few moments. Don't refresh or close the page after you make your payment. After you make the payment it will take you to our website. Yes, I understand EmailThis field is for validation purposes and should be left unchanged.
