6670 267 St Aldergrove, BC, Canada V4W 3L8 -- 604.607.5007
Gloucester Downs Equestrian Park
Home
About
News
Stallions
VAUST S
Callebault
Coeur de Chasse
For Sale
Lessons
EC Rider Levels
Rates
Clinics
Camps & Tour
Registration for Camps
Sign up for Spruce Meadows Masters Tour
Contact Us
New Page
There has been an issue getting the form below to be secure, so the form has been rebuilt on a secure site. Click on the button to go to a secure form:
secure registration
Registration for Equine Studies Canada Camps
*
Indicates required field
Name
*
First
Last
Gender
*
male
female
Date of Birth
*
Email
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Phone Number
*
Secondary parent/guardian
*
First
Last
Secondary Parent Address
*
Line 1
Line 2
City
State
Zip Code
Country
Secondary Parent Email
*
Participant's Name
*
First
Last
Nick Name
*
Gender
*
Male
Female
Date of Birth
*
Email
*
Phone Number
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Do you speak english?
*
Yes
No
Some
Primary language spoken
*
Previous Equine Experience
*
None
Days
Months
1-2 years
3-5 years
More
Daily horse care, not including riding. All campers should indicate here how often they have done all the care for a horse for a full day.
Previous Riding experience
*
None
Days
Months
1 year
2 years
3-5 years
more than 5 years
Choose one, if you choose something other than days or months please ensure that you have ridden at least three times a week for this period.
Do you have valid visitor's health insurance for Canada for the duration of your stay?
*
yes
No
Has the participant had any previous serious injuries by any cause?
*
None
Head injury
Back injury
Broken bones
Internal organs
other
Please add notes about any serious injuries or pre-existing medical conditions in the Medical Notes section below
Does the Participant have pre-existing medical conditions
*
yes
no
minor
Please give all the information and how this should be handled by stating details in the following box.
Medical Notes: details of previous serious injuries or Medical Health conditions
*
Please indicate NONE, or indicate all prior serious injuries or trauma, as well as any existing medical conditions such as allergies, ADHD, poor sight, dyslexia, epilepsy, bi-polar, anorexia, etc.
Please register the participant for the following Camps
*
ESC Spring Break Groom School April 20 - May 04
Summer Camp for dates below
Please register the participant for
*
Groom School Summer Program
Rider Levels Summer Program
Option for Tuition only or tuition and hotel
*
Tuition Only
Tuition and Hotel
I wish to register the Participant for ESC Summer Camps for the following weeks in the
*
Week 1 June 29, 2014 - July 06, 2014
Week 2 July 06 - July 13,2014
Week 3 July 13 - July 20,2014
Week 4 July 20- July 27, 2014
Week 5 July 27, 2014 - August 03, 2014
Week 6 August 03, 2014 - August 10, 2014
Week 7 August 10, 2014 - August 17, 2014
Week 8 August 17, 2014 - August 24, 2014
Please choose all the weeks that you wish to at ten the camp for the program that you selected above.
Participants coming for Rider Levels
*
I am bringing my horse
I am not bringing a horse
Please fill this in if you want to bring your horse to camp. Board is $787.50/mo or $200/week (price includes tax)
Preferred method of payment
*
Visa
Mastercard
American Express
Direct Debit
Submit