Willington Hills Summer Riding Program Sign Up Form

Session Dates for 2010: (Check the session you're applying for)
Full Day Sessions
Half Day Sessions
[ ] Session 1: July 5 - July 9 (Full!) [ ] Half Day Session 1: July 19 - 23
[ ] Session 2: July 12 - July 16 [ ] Half Day Session 2: Aug 16 - 20
[ ] Session 4: Aug 2 - Aug 6 Half-day campers may join full day sessions if space
[ ] Session 5: Aug 9 - 13 is available. Call to ask.


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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 06278