Horseback Riding, Lessons, Grooming, Stables, Indoor Arena, Horse Sales, Rising Stars Equestrian Center LI, NY

Summer Program Registration

More about our Summer Program...

Please fill in the appropriate fields. Required fields are marked with an asterik (*)

Parent/Guardian Name:*
Address:*

Home Phone:*
Work Phone:*
Cell Phone:*
We will not share your email with anyone.
Email:

Child's Name:*
Date of Birth (mo/day/yr):*
Additional Child's Name:
Date of Birth (mo/day/yr):
Additional Child's Name:
Date of Birth (mo/day/yr):

In case of an emergency please notify
(if parents/guardian are not available):

Name:* Relationship:*
Home Phone:*
Cell Phone:*

Health Information:
Handicaps, allergies (including food allergies), medication use, etc.

Enrollment:
List Individual Days:

Or please select your desired enrollment weeks below:

June 28 - July 2

July 6 - July 9

July 12 - July 16

July 19 - July 23

July 26 - July 30

August 2 - August 6

August 9 - August 13

August 16 - August 20

A 10% Non-Refundable Deposit is required to hold a camper's spot.