Rockbridge SPCA Animal Adventure Camp June 27th- July 1st

9:00am-1:00pm

For Boys and Girls ages 5-12 www.rockbridgespca.net [email protected]

Location: 10 Animal Place Lexington, just off Greenhouse Rd. Mailing address: PO Box 528 Lexington, VA 24450

540-463-5123

For children with special needs, please ask about our scholarships provided by Washington and Lee University. Call Tara for more information.

What to Expect:

Animal Adventure Camp Registration Form Camper’s Name _______________________________Age ___ DOB_________ Gender___ Parents/Guardian’s Name _____________________________________________________ Address ___________________________________________________________________ Phone Number ___________________Email _______________________________________ Emergency contact ______________________________Phone Number_________________ List any allergies __________________Camper’s favorite animal ________________________ T-Shirt Size, circle one: Youth XSmall, Small, Medium, Large or Adult Small, Medium, Large, XLarge Tuition $150.00 includes the week long camp, T-Shirt and SPCA water bottle and snacks. Family discount subtract $20.00 per additional child. Copy this form for additional registrations. $50.00 deposit per camper is due at time of registration, non-refundable after June 3rd, full payment due June 17th. Deadline to register is June 3rd. Amount paid: _________________________________________

____ Please check this section if you are a returning Animal Ambassador Age 12 and up from last year’s Animal Adventure Camp and would like to be a classroom assistant for this year’s Camp. Tuition fee only $20.00 to cover the cost of T-Shirt, water bottle and snacks. Please fill out registration form above.

As your child will be taking part in an SPCA activity/event we would like to ask for your consent to take photographs of the activity /event that may contain images of your child. The images would be used for publicity for future events, leaflets, websites, newsletters, grant applications, etc. I _________________________________ Consent to ________Do not consent to ________, Giving permission to the Rockbridge SPCA to take photographs. Please see the back of this form for our camp field trip to Hoof-Beats Therapeutic Riding Center at The Virginia Horse Center, 487 Maury River Rd. Lexington, VA 24450

Non-Profit Org. U.S. Postage

PAID Lexington, VA Permit No. 44

We will be taking a field trip to Hoof-Beats Therapeutic Riding Center at The Virginia Horse Center, Wednesday, June 29th during camp hours. Please go on-line to print and fill out the Hoof-Beats liability form that will need to be included with your Animal Adventure Camp registration. www.hoof-beats.com Go to “forms” and select #2 “Liability and Hold Harmless Agreement”

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