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Attendee Information
First/Middle/Last Name      
Address1  
Address2
City/State/Zip      
Date of Birth:  Month:   Day:     Year:  
Age:  
Sex:  
Years attended Red Cedar:   
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?
   
Camps
Discovery Kids Camp
Please indicate your first and second date choices for this camp

Cost: 150.00		  July 13-17

 July 20-24

Aug 10-14 

 Aug 17-21

Range Riders
 Please indicate your first and second date choices for this camp

Cost: 275.00		  July 13-17
 
 July 27-31 

 Aug 3-7

 Aug 10-14
Adventure Camp
 Please indicate your first and second date choices for this camp

 
Cost is determined based on the camper's level of assistance.   Please contact us for more information.
July 13-17
July 20-24
July 27-31
Aug 3-7 
Aug 10-14
Aug 17-21
Quest  Camps

Cost is determined based on the camper's level of assistance.   Please contact us for more information.

Customized Camps



 ACT June 15-19
** Call 260-609-7412 to register 

DSANI July 6-10 (Members Only)
** Call DSANI at 260-471-9964

 AWS Group Homes June 1-5
 
Juvenile Diabetes
 Juvenile Diabetes
 June 22-26 Cost: $275.00
Horseback Riding Lessons
Select Program:
 Please indicate your first and second date choices for this camp

    * We will call you to schedule riding times

     Session 1: Feb 23-Apr 3

      Session 2: April 13-May 22       

       Session 3 : May 25-July 3        

      Session 4 : July 13-Aug 21         
    
     Session 5 : Aug 24-Oct 2         

     Session 6 : Oct 12-Nov 20     

     Session 7 : Jan 11-Feb 19, 2010      
Select Program:
 Please indicate your first and second date choices for this camp
 
     Session 1: Feb 23-Apr 3  (Mondays)
      English:: 4:30pm - 5:30pm
      Western: 5:45 - 6:45pm

    Session 2: April 13-May 22 (Mondays)
       English:: 4:30pm - 5:30pm
       Western: 5:45 - 6:45pm


     Session 3 : May 25-July 3 (Mondays)
      English: 4:30pm - 5:30pm
       Western: 5:45 - 6:45pm


     Session 4 : July 13-Aug 21 (Mondays)
       English: 4:30pm - 5:30pm
       Western: 5:45 - 6:45pm

    Session 5 : Aug 24-Oct 2 (Mondays)
       English:4:30 - 5:30pm  
      Western: 5:45 - 6:45pm

    Session 6 : Oct 12-Nov 20 (Mondays)
      English: 4:30 - 5:30pm  
      Western: 5:45 - 6:45pm
   
    Session 7 : Jan 11-Feb 19, 2010 (Mondays)
       English: 4:30 - 5:30pm 
       Western: 5:45 - 6:45pm

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

     Session 1: Feb 23-Apr 3 (Tuesdays)
      English: 4:30pm - 5:30pm
      Western: 5:45pm - 6:45pm


    Session 2: April 13-May 22 (Tuesdays)
       English: 4:30pm - 5:30pm
       Western: 5:45pm - 6:45pm

     Session 3 : May 25-July 3 (Tuesdays)
        English: 4:30pm - 5:30pm  
        Western: 5:45pm - 6:45pm

     Session 4 : July 13-Aug 21 (Tuesdays)
        English: 4:30pm - 5:30pm  
        Western: 5:45pm - 6:45pm

    Session 5 : Aug 24-Oct 2 (Tuesdays)
       English: 4:30pm - 5:30pm
      Western: 5:45pm - 6:45pm 

    Session 6 : Oct 12-Nov 20 (Tuesdays)
       English: 4:30pm - 5:30pm
       Western: 5:45pm - 6:45pm 
   
    Session 7 : Jan 11-Feb 19, 2010 (Tuesdays)
       English: 4:30pm - 5:30pm
       Western: 5:45pm - 6:45pm
Private Lessons
Select Session:
 		Private Lessons ($270 per 6 week session, 6 lessons or $45/hour)
* We will call you to schedule riding times
 Session 1: Feb 23-Apr 3    
 Session 2: April 13-May 22
 Session 3 : May 25-July 3    
 Session 4 : July 13-Aug 21
 Session 5 : Aug 24-Oct 2  
 Session 6 : Oct 12-Nov 20
 Session 7 : Jan 11-Feb 19, 2010  
Therapeutic Riding
Select Session:
 Please indicate your first and second date choices for this camp

 Therapeutic Riding
Cost is determined based on the rider's level of assistance needed. Please contact us for more information.

Wednesdays and Thursday evenings during all sessions
 Session 1: Feb 23-Apr 3    
 Session 2: April 13-May 22
 Session 3 : May 25-July 3    
 Session 4 : July 13-Aug 21
 Session 5 : Aug 24-Oct 2  
 Session 6 : Oct 12-Nov 20
 Session 7 : Jan 11-Feb 19, 2010 
 Single Lesson : $45.00
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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