Trilliumview Riding School
1060 Burnhamthorpe Rd
Oakville Ontario L6M 4K8
905-257-2233

*Application for Summer Camp 2011*

Name of Student ____________________________________OHIP Number_______________

Name of Guardian ___________________________________Birth Date__________________

Address________________________________________________________________________

Telephone Numbers:

Home:____________________________________________

Office Mother :_______________________Office Father:______________________________

Mother Cell: ___________________________Father Cell: _____________________________

Family Physician : _______________________Phone : ____________________________

Allergies : _______________________________________________________________________

Previous Riding Experience:

_______________________________________________________________________________

_______________________________________________________________________________

Circle the week you are Applying for :

    Camp Weeks
    July 4 - 8
    July 11 - 15
    July 18 - 22
    July 25 - 29
    Aug 8 -12
    Aug 15 - 19
    Aug 22 - 26

Total payment for 5 day Camp 250.00 plus HST
Please make cheques payable to Trilliumview Stables
No charge for helmet rental but please come and reserve yours in advance.