Registration
Buckhead Horse Camp
at
Chelford Farm
Registration
Session _______________
Name of Rider: ______________________________ Age: __________
Schooling Level: pre-amoeba amoeba tadpole beginner novice novice training
Address _______________________________________________________________
City ______________________________ State ________ Zip _______________
Parent's Name
______________________________________________________________
Phone _________________________ Cell (for emergency)________________________
Special medical considerations: (i.e. Asthma)
______________________________________
Special medications
__________________________________________________________
Horse's name ______________________ Age _____ Height ______ Breed
____________
******************************************************************************
Release:
My child will be participating in an educational equine activity at Chelford Farm, 1651 Oconee
Road, Buckhead, Georgia 30625. I understand that (his/her) participation involves inherent
risks associated with the dangers and conditions which are an integral part of equine
activities. I also understand that at certain times my child may be traveling off the farm in
company of camp advisors for shopping, dinner, swimming, or other activities. I release and
agree to hold harmless the activity organizer, family members, volunteers and instructors
assisting at Buckhead Horse Camp from all liability for negligence resulting in accidents,
damages, illness and injury of rider and/or horse.
Signed: _______________________________________________ (parent or guardian)
Date: ________________
(706)342-4166 Phone
Please mail to:
Chelford Farm
P.O. Box 1
Buckhead, GA 30625
or fax: (706) 342-2536
at
Chelford Farm
Registration
Session _______________
Name of Rider: ______________________________ Age: __________
Schooling Level: pre-amoeba amoeba tadpole beginner novice novice training
Address _______________________________________________________________
City ______________________________ State ________ Zip _______________
Parent's Name
______________________________________________________________
Phone _________________________ Cell (for emergency)________________________
Special medical considerations: (i.e. Asthma)
______________________________________
Special medications
__________________________________________________________
Horse's name ______________________ Age _____ Height ______ Breed
____________
******************************************************************************
Release:
My child will be participating in an educational equine activity at Chelford Farm, 1651 Oconee
Road, Buckhead, Georgia 30625. I understand that (his/her) participation involves inherent
risks associated with the dangers and conditions which are an integral part of equine
activities. I also understand that at certain times my child may be traveling off the farm in
company of camp advisors for shopping, dinner, swimming, or other activities. I release and
agree to hold harmless the activity organizer, family members, volunteers and instructors
assisting at Buckhead Horse Camp from all liability for negligence resulting in accidents,
damages, illness and injury of rider and/or horse.
Signed: _______________________________________________ (parent or guardian)
Date: ________________
(706)342-4166 Phone
Please mail to:
Chelford Farm
P.O. Box 1
Buckhead, GA 30625
or fax: (706) 342-2536
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