Willington Hills Summer Riding Program Sign Up Form
Session Dates for 2008: (Check the session you're applying
for)
[ ] Session 1: July 7- July 11
[ ] Session 2: July 14 - July 18
[ ] Session 3: July 28 - Aug 1
[ ] Session 4: Aug 4 - Aug 8
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Parent's Name
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Child's Name
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Child's Age
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Addess Line 1
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City, State, Zip
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Phone Number (Days)
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Phone Number (Evenings)
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Cel Phone Number
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Emergency Contact Name
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Emergency Phone Number(s)
I, _____________________________, do / do not give permission to Willington Hills staff to take pictures of ______________________.
Signature ______________________________Please return to:
Willington Hills Equestrian Center
34 Cemetery Road
Willington, CT 06278