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Summer Camp 2004 Application
Print out this blank form, fill out each section completely, and mail it to us with your deposit check. We will contact you to confirm your placement.
| Camper's Name | Birthdate | |
| Address | ||
| City/Town | State | Zip |
| Parents/Guardian | ||
| Work Phone | Home Phone | |
| Additional Emergency Contact | ||
| Daytime Phone | Home Phone | |
Camp Weeks for 2004: Coming Soon
Your signature below constitutes an agreement and affirmation that you and your child participate voluntarily, fully aware that horse sports, horseback riding and associated activities involve inherent dangerous risk. By participating, you and your child expressly assume all risks of injury or loss, and you and your child agree to hold Happy Daze Farm, Donald and Lorraine Rich, Pamela Rich, Shelby Rich Purchase, employees and agents harmless of any injury or loss suffered during or in connection with horse sports, horseback riding and stable management at Happy Daze Farm.
-------WARNING------
Under Vermont Law, an equine activity sponsor is not liable for an injury to, or the death of, a participant in equine activities resulting from the inherent risks of equine activities that are obvious and necessary, pursuant to 12 V.S.A. 1039.
| Parent Signature(s) | Date |
Happy Daze Farm Equestrian Facility |
1640 Brookfield Rd.....Berlin VT 05602.....1(802)229-9551.....E-Mail |
