Willington Hills Summer Riding Program Sign Up Form

Session Dates for 2015: (Check the sessions you're applying for)

Full Day Sessions ($425)
Half Day Sessions ($225)
[ ] Session 1: July 13-17 [ ] Half Day Session 1: July 6-10
[ ] Session 2: July 27-31 [ ] Half Day Session 2: July 20-24
[ ] Session 3: Aug 10-14 [ ] Half Day Session 3: Aug 10-14
Half-day campers may join full day sessions if space is available. Call to ask. (860) 684-4849

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Parent's Name
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Child's Name
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Child's Age          Parent's Email Address
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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 ______________________________

Date of Signature ________________________

Please return to:

Willington Hills Equestrian Center
34 Cemetery Road
Willington, CT 06279