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

Camper #1 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 #2 AGE required

Camper #2 NAME:

Camper #4 NAME:

LIST ANY ALLERGIES or medical info we should know here or type in "none" to continue *

Camper #4 AGE required:

Electronic Signature *

Photo Waiver *

Click here that you hereby understand, acknowledge and agree that your child(s) photo may be used for advertising, or posted on the farm social media outlets.

Email Address: *

ADD EARLY DROP off (8:30a.m.-8:50a.m.) *

Yes! I will need early drop off.

No! Not at this time.

Parent Name: *

ADD FRIDAY to my camp (additional $90) *

Yes! I want to add Friday

No, Not at this time

NOTES

ADD EXTENDED DAY/LATE PICK UP (3p.m.-4p.m.)

Yes! I would like to add extended day.

No, not at this time.

Medical Release *

Check here that IN CASE OF EMERGENCy or if medical care is needed for the above participants listed that you authorize medical or emergency care as deemed necessary by emergency medical personnel or facility providing treatment.

Camper #3 NAME

Camper #3 AGE

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

Phone: *

Camper #1 AGE *

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.

Mailing Adress: *

Liability Waiver *

Please check here that you fully understand and agree to the 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 the playground equipment, participating in riding, grooming, participating in camp activities, games, water activities, and all camp related activities could give rise to injury to your child the participant, yourself, or your guests at no fault of instructors, trainers, owners, or affiliates of this farm. By checking this box and submitting this form 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, affiliate, or act of participation, any equipment, Act of God, or Mother Nature while on the premises of 3497 N. Cleveland Road, Lexington, KY 40516. This waiver and release of liability also includes KRS 247.4207, KRS laws posted in the barn, and any further state laws where the participant knowingly and willingly assumes al liability for any damage, injury, death, other that could occur during farm, riding, or camp related activities. By typing your name you are stating you are the parent or legal guardian of the listed participant(s) on this form and are legally signing this release and do hereby release and discharge all 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 in full legal force and effect. "I the parent or legal guardian of sound mind and legal age fully understand and acknowledge this agreement and waiver.".