Pony club application form 2012

1. Croxteth Park Pony Club Centre
Camp Application Form 2012
Mini Camp Tues 31st July – Thurs 2nd August 9:30am – 4.30pm £110
Camp Mon 13th – Fri 17th August 8.30am – 5.30pm £200
Includes a coach trip to the National Pony Club Championships
at Cholmondeley, Cheshire (16th Aug, time to be arranged –
some places for mini-campers and adults too)
Camp (tick) or Mini Camp (tick)
Name
Address
D.O.B.
Membership no & expiry date
Contact name
Contact tel no
Relationship
Second Contact name
Contact tel no
Relationship
Achievement badges & tests done (must be filled in)
Details of any allergies or medical conditions
Signature of parent/guardian
Deposit (£20 with booking, balance 1 week before camp)
Extra coach trip place (name & adult/minicamper)
One form for each member (please ask about discounts for 2nd family members)
Please also fill in the photographic consent form