Three Crowns Farm - Horse Boarding Facilities, Horseback Riding Lessons, Horseback Riding Camps

ADD EXTENDED DAY from 3p.m.-4p.m. $12 per day *

Yes, I want to add Extended Day to my camp week(s)

No, I do not want to add Extended Day at this time.

EMERGENCY CONTACT NAMES AND CELL NUMBERS *

Camper #2 Name

REGISTRATION - $100 dep required

Note: you must fill out every field with a red asterisk. If a field is skipped the 'submit' button will not work.

Camper #1 Name *

Form may not be very mobile friendly. Use a personal Computer to register your camper if having trouble! Please call 806-1000 for information or help with registration. You will receive an email approximately a week before your camp date with reminders on what to wear and bring to camp.

ELECTRONIC SIGNATURE: *

Age of Camper #3

Photo Waiver *

I hereby understand and acknowledge that my child's photo may be used for advertising and/or be posted on the farm social media outlets

Age of Camper #2

Age of Camper #1 *

Phone *

Mailing Address *

Email Address: *

ADD FRIDAY to my camp week for an additional $90 *

Yes, I want to add Friday to my camp week(s)

No, I do not want to add Fridays at this time.

ADD EARLY Drop 8:30-8:50a.m. $12 per day *

Yes, I want to add Early drop off to my camp week(s)

No, I do not want to add Fridays at this time.

Medical Waiver *

Check here that IN CASE OF EMERGENCY or if medical care is needed for the above participants listed on this form and/or attending this camp, that you authorize medical or emergency care as deemed necessary by emergency medical personnel or facility providing treatment.

Liability Waiver *

Please check here that you fully understand and agree to this waiver and that you hereby fully acknowledge that being in a farm environment, riding or handling horses, being on the premises where horses are present, handling other farm animals, playing on playground equipment, participating in riding, participating in camp activities, games and all farm and camp activities could give rise to injury to you, your participating child, or guests at no fault of instructors, trainers, owners, or affiliates of the farm. You hereby waive any and all claims of damages, therefrom to which you may be entitled, resulting from any action by any horse, instructor, trainer, owner, animal, equipment, Act of God or Mother Nature while on the premises of 3497 N. Cleveland Road, Lexington, KY 40516. This is a waiver and release of liability and also includes KRS 247.4027 and any further state laws where the participant knowingly and willingly assumes all liability for any farm activity, riding activity and/or camp related activity. By typing your name as the parent or legal guardian of the listed participant(s) on this form and clicking this box you are legally signing this release and do hereby release and discharge 3497 N. Cleveland Road, Lexington KY, the farm, owners, or affiliates and consider them all "released parties". You hereby understand and agree that this waiver is intended to be as broad and inclusive as permitted by the laws of Kentucky and agree that if a portion is held invalid, the remainder of the waiver will continue if full legal force and effect. By clicking this box "I affirm that I fully understand and acknowledge and am of legal age and sound mind to sign this agreement.

Camper #3 Name

LIST ANY AND ALL ALLERGIES or information we should know. Type "NONE" if no allergies *

Camps are Monday through Thursday with an option to add Friday, early drop and extended day on this registration form.

Parent Name: *