Summer Camp Registration

Please choose the week you wish to register for:*

July 10 – 14
July 17 – 21
July 24 – 28
July 31 – August 4
August 14 – 18

Please check the appropriate boxes if your child has a special need. A pre-assessment may be necessary to determine if there are supportive needs.

Physical
Emotional
Psychological

Campers Name*

First Last

Home Phone*

Date of Birth*

Address*

Street Address City Province Postal Code

Camper's Health Card Number*

Age (as of first day of camp)*

Height*

Weight (in LBS or KG - please specifiy)*

Parents Name*

First Last

Contact Phone Number*

Cell Phone Number

Email Address*

Please provide information regarding Asthma, Medications, Allergies:

Is assistance required for activities of daily living? Example: feeding, lifts and transfers, dressing and toileting. Please explain.

A support worker may need to be provided, and will depend on the individual needs of the camper.

If applicable, please include a brief explanation of your or your child's riding experience. A pre-assessment may be required if WETRA sees fit for safety purposes.

I agree to sign the waiver, pertaining to all activities, at the Windsor-Essex Therapeutic Riding Association on arrival of the first day of camp.*

I agree
I DO NOT agree

Summer Break Camp Registration

(250.00 will be refunded if you cancel your registration)

Total

$ 0.00 CAD

Method of Payment:*

Credit Card
e-Transfer

Credit Card*

Card Details

Cardholder Name

e-Transfer Instructions:

Please send an e-Transfer to info@wetra.ca. No security question will be required.

Phone

This field is for validation purposes and should be left unchanged.

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2023 Summer Break Camp Registration

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