Camp Form

FREEDOM FARMS

BARKSDALE FREEDOM FARMS LLC -202 CR 360- P.O. Box 44- 78828

Camp Form

Please fill out the following information completely and return with a $50 deposit.

Student Name_____________________________________________________

Address__________________________________________________________

Phone___________________________

Cell Phone________________________

Age__________

Level of riding experience_______________________________

Level of horse's training_____________________________________________
(Does not apply if using camp horse)
Describe any current problems________________________________________

________________________________________________________________

Dietary Restrictions_________________________________________________

Prescriptions, Dosage, & Times_______________________________________

Swimming Ability___________________________________________________

I give my permission for an EMS or manager of Freedom Farms to transport my child to the nearest medical facility in case of an emergency._______________________________________________________

I give my permission for medical treatment of my child in case of illness or an emergency.

________________________________________________________________________
July 30- Aug.3

All horses will need a current coggins & will need to be shod. Your check list is on the next page.
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$75 per day-other family members $50 per day

FREEDOM FARMS
P.O. BOX 44
Barksdale, TX 78828
830-234-3284 713-598-3610