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 ______________________.

Please return to:

Willington Hills Equestrian Center
34 Cemetery Road
Willington, CT 06278