Red Cedar Registration

Attendee Information

First/Middle/Last Name

Address1

Address2

City/State/Zip

Date of Birth:

Month: Day: Year:

Age:

Sex:

Male Female

Parent/Guardian Information:

First/Middle/Last Name

Address1

Address2

City/State/Zip

Home Phone

Alternate Phone

Email:

Emergency Contact Information

Name

Relationship to Attendee

Home Phone

Work Phone

Other Phone

Pick up Authorizations

Authorized Name

Authorized Phone

Authorized Name

Authorized Phone

Please list medical conditions or allergies:

How did you hear about Red Cedar?

Years attended Red Cedar:

Camps

Discovery Kids Camp Please indicate your first and second date choices for this camp Cost: 150.00	July 7-11 (08D1) July 14-18 (08D2) July 21-25 (08D3) Aug 11-15 (08D4)	Range Riders Please indicate your first and second date choices for this camp Cost: 275.00	July 14-18 (08R1) July 28-Aug 1 (08R2) Aug 4-8 (08R3) Aug 11-15 (08R4)

Adventure Camp Please indicate your first and second datechoices for this camp Cost: 325.00	July 7-11 (08A1) July 14-18 (08A2) July 21-25 (08A3) July 28-Aug 1 (08A4) Aug 4-8 (08A5) Aug 11-15 (08A6)	Quest Retreat Cost: 625.00/overnight 550.00/day only	June 9-13 (08Q1) Residential Overnight ($625) Day Only ($550)
		Specialty Camps* (members only) Please indicate your first and second date choices. Cost: 325.00 Early Bird Discount does not apply to specialty camps	ACT June 16-20** Call 260-609-7412 to register (08S2) DSANI June 23-27 (08S3) AWS OHIO - June 2-6 (08S1) AWS Group Homes Aug 18-22 (08S5)
		Juvenile Diabetes Cost: $275.00	June 30-July 4 (08S4)

Horseback Riding Lessons (Early Bird Discount does not apply)

Select Program:
Please indicate your first and second date choices for this camp

Little Cowpokes ($150) (08LC)

   Session 1: April 21 - May 30 (Mondays)
Western: 4:30 - 5:30pm (08LC1W)

   Session 2: June 2 - July 11 (Mondays)
   Western: 4:30 - 5:30pm (08LC2W)

Fall Session : Oct 13 - Nov 11 (Mondays)
   Western: 4:30 - 5:30pm (08LCFALL)

Winter Session 1 : Jan 12, 2009 - Feb 20, 2009 (Mondays)
   Western: 4:30 - 5:30pm (08LCWinter1)

Winter Session 2 : Feb 23, 2009 - April 3, 2009 (Mondays)
   Western: 4:30 - 5:30pm (08LCWinter2)

Select Program:
Please indicate your first and second date choices for this camp

Buckaroos ($210) (08BU)

   Session 1: April 21 - May 30 (Mondays)
   Western: 5:15pm - 6:15pm (08BU1W)
   English: 6:30pm - 7:30pm (08BU1E)

Session 2: June 2 - July 11 (Mondays)
Western: 5:15pm - 6:15pm (08BU2W)
English: 6:30pm - 7:30pm (08BU2E)

   Session 3: July 21 - Aug 29 (Mondays)
   Western: 5:15pm - 6:15pm (08BU3W)
English: 6:30pm - 7:30pm (08BU3E)

   Session 4: Sept 1 - Oct 10 (Mondays)
Western: 5:15pm - 6:15pm (08BU4W)
English: 6:30pm - 7:30pm (08BU4E)

Fall Session : Oct 13 - Nov 11 (Mondays)
   4:30 - 5:30pm (08BUFALL)

Winter Session 1 : Jan 12, 2009 - Feb 20, 2009 (Mondays)
   4:30 - 5:30pm (08BUWinter1)

Winter Session 2 : Feb 23, 2009 - April 3, 2009 (Mondays)
   4:30 - 5:30pm (08BUWinter2)

Select Program:
Please indicate your first and second date choices for this camp

Trail Blazers ($210) (08TB)

   Session 1: April 21 - May 30 (Tuesdays)
   Western: 4:30pm - 5:30pm (08TB1W)
   English: 5:45pm - 6:45pm (08TB1E)

Session 2: June 2 - July 11 (Tuesdays)
Western: 4:30pm - 5:30pm (08TB2W)
English: 5:45pm - 6:45pm (08TB2E)

   Session 3: July 21 - Aug 29 (Tuesdays)
   Western: 4:30pm - 5:30pm (08TB3W)
English: 5:45pm - 6:45pm (08TB3E)

   Session 4: Sept 1 - Oct 10 (Tuesdays)
Western: 4:30pm - 5:30pm (08TB4W)
English: 5:45pm - 6:45pm (08TB4E)

Fall Session : Oct 13 - Nov 11 (Mondays)
   4:30 - 5:30pm (08TBFALL)

Winter Session 1 : Jan 12, 2009 - Feb 20, 2009 (Mondays)
   4:30 - 5:30pm (08TBWinter1)

Winter Session 2 : Feb 23, 2009 - April 3, 2009 (Mondays)
   4:30 - 5:30pm (08TBWinter2)

S.P.U.R.S.

Please indicate your first and second date choices for this program

S.P.U.R.S ($150 per 6 week session, 6 lessons)
Monday and Tuesday evenings during all sessions, 6pm-7pm

Session I: April 21 - May 30 (08SPUR1)
Session II: June 2 - July 11 (08SPUR2)
Session III: July 21 - Aug 29 (08SPUR3)
Session IV: Sept 1 - Oct 10 (08SPUR4)
Fall Session : Oct 13 - Nov 11 (08SPURFALL)
Winter Session 1 : Jan 12, 2009 - Feb 20, 2009 (08SPURWinter1)
Winter Session 2 : Feb 23, 2009 - April 3, 2009 (08SPURWinter2)

Private Lessons

Select Session:

Private Lessons ($270 per 6 week session, 6 lessons or $45/hour)
Please call to schedule your session

Session I: April 21 - May 30 (08PL1)
Session II: June 2 - July 11 (08PL2)
Session III: July 21 - Aug 29 (08PL3)
Session IV: Sept 1 - Oct 10 (08PL4)
Fall Session : Oct 13 - Nov 11 (08PLFALL)
Winter Session 1 : Jan 12, 2009 - Feb 20, 2009 (08PLWinter1)
Winter Session 2 : Feb 23, 2009 - April 3, 2009 (08PLWinter2)

Therapeutic Riding

Select Session:
Please indicate your first and second date choices for this camp

We will contact you with the total amount, however you can register now to reserve your spot.

Therapeutic Riding ($150 per 6 week session, 6 lessons)

Wednesdays and Thursday evenings during all sessions, 30 minutes each
Session I: April 21 - May 30 (08TR1)
Session II: June 2 - July 11 (08TR2)
Session III: July 21 - Aug 29 (08TR3)
Session IV: Sept 1 - Oct 10 (08TR4)
Fall Session : Oct 13 - Nov 11 (08TRFALL)
Winter Session 1 : Jan 12, 2009 - Feb 20, 2009 (08TRWinter1)
Winter Session 2 : Feb 23, 2009 - April 3, 2009 (08TRWinter2)

Participation Agreement

I/we grant permission for the applicant to participate in planned activities. In case of accident or illness, Camp Red Cedar is authorized to secure emergency medical treatment. Camp Red Cedar is not responsible for lost, stolen or damaged personal articles. I/we also authorize Camp Red Cedar to have and use photographs, slides, and video of the person named on this registration as may be needed, for its marketing purposes. I/we agree to waive any claims against Camp Red Cedar , its staff and volunteers for injuries or damages that may result from the conduct of other persons including participants in Camp Red Cedar programs. I/we approve this registration and agree to pay the balance of the costs by June 1, and understand that camp costs, riding lessons and deposit are not refundable under any circumstances.

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