Please note that your camp spot is not secure until we receive a deposit.
YOU ONLY NEED TO SUBMIT THIS ENTIRE FORM 1X EACH YEAR. IF WE HAVE IT ON FILE FOR YOU ALREADY, ONLY FILL OUT THE FIRST PAGE, INDICATING YOUR CAMP PREFERENCE AND CONTACT INFO, INCLUDING EMAIL. FOR ALL DAY CAMPERS,YOU MAY SKIP ANY OVERNIGHT INFO. THANKS!
For campers who come to us with some horse experience, we offer the opportunity to be a Wrangler or Junior Wrangler. Wranglers must demonstrate the ability to lead and tie a horse safely, and handle the horse for tacking, grooming, etc. Wranglers are allowed to help catch horses, apply fly spray, feed horses snacks in the afternoon, and assist with other horse related chores. Junior Wranglers must demonstrate the ability to lead a horse safely and are allowed to assist with leading horses back and forth between pastures and riding arena. Campers often come to us green, but become Wranglers/Jr. Wranglers throughout the course of camp. For those who do not pass the test, they are still able to assist with all horse related chores that don't involve handling a horse independently.
I WOULD LIKE TO TAKE THE WRANGLER TEST AT CAMP: Y N
At this time I classify myself as a (please circle): Wrangler Jr. Wrangler Complete Beginner
Session Dates you prefer:
The different camps run concurrently. This means that friends attending different camps can attend the same week.
Aug 6-11, 2017
Email Address: ______________________________________________________________________________
Print carefully. We create a database of emails for all campers in a specific session. It is our main form of communication.
Health Card Number or Medical Insurance:_______________________
Citizens other than American may be required to provide a credit card if medical attention is needed.
Does your camper want to ride English (Jumping, Hunt Seat, Dressage) or Western seat? ___________________
This is only to help us determine general interest in each discipline. Every camper has the option of choosing a different discipline once at camp.
What are your riding goals? __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
What are you looking forward to doing at camp other than riding? ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Does the camper have any emotional, behavioral, physical, allergic or other conditions of which we should be aware? :_______________________________________________________________________________________________________________________________________________________________
Please let us know of any dietary restrictions to help us in planning menus. If we are not made aware of special diets here, we will not have the necessary ingredients to provide appropriate alternative dishes_________________________________________________________________________________________________________________
Release executed on the ____ day of _______, 20___by _____________________( the ‘Releasor’) and minor child_______________________ of (Address) _________________________, (City)_______________(State)_____
(County)____________, to Chastain Mist and Company, and all agents .
Conditions of Registration: I, the parent/guardian of the above-named participant, release Chastain Mist Summer Camp, Chastain Mist and Co., The Spotlite Foundation, its director, staff and agents from any loss, personal injury, accident, misfortune or damage to the above- named camper or his/her property, with the understanding that reasonable precautions shall be taken to ensure the health and safety of the above-named camper. The camp director reserves the right to dismiss a camper who, in the opinion of the director, is a hazard to the safety and rights of others or who appears to have rejected the reasonable controls of camp. No refund will be made for dismissals due to disciplinary action. Each camper must be covered by medical insurance. The parent/guardian certifies that the camper is in good health, normal in condition and habits, and is amenable to camp life. By signing this form the parent/guardian is giving the camp staff the right to obtain medical attention necessary for the campers welfare and good health. The parent/guardian is responsible for all costs incurred. I hereby give permission for my son/daughter to participate in the entire program, and permission for Chastain Mist Summer Camp to act in my behalf in case of sickness or emergency. I give permission to Chastain Mist Summer Camp and the Spotlite Foundation to use any photograph or video of my child for promotional material and that my positive statements about Chastain Mist Summer Camp may be used as testimonials in materials publicizing the camp program.
I, The Releasor, in consideration of my minor son or daughter or self being permitted to participate in any Chastain Mist and Company or The Spotlite Foundation program, including but not limited to riding Lessons, riding camp, horse boarding, field trips, trail rides, run and/or operated by the Releasee, WAIVE, RELEASE, and DISCHARGE the Releasee, his/her heirs, executors, administrators, legal representatives and assigns from all liability for or by reason of any damage, loss, or injury to person and property, even injury resulting in death of myself or above named minor child, which has been or may be sustained in consequence of the Releasor’s participation or the participation of the Releasor’s child in the activity described about, and notwithstanding that such damage, loss or injury may have been caused solely or partly by the negligence of the Releasee.
I hereby acknowledge and agree that I have carefully read this Waiver and Release agreement, that I full understand same, and that I am freely and voluntarily executing same.
By signing this release I will be forever prevented from suing or otherwise claiming against the Releasee for any property loss or personal injury that I may sustain while participating in or preparing for the above noted activity.
I have been given the opportunity and have been encouraged to seek independent legal advice prior to signing this Waiver and Release agreement.
I understand that this Waiver and Release agreement is binding on me, my spouse, my heirs, my executors, administrators, personal representatives and assigns.
I acknowledge that I do not have nor does my minor child have any physical limitations, medical ailments, physical or mental disabilities that would limit or prevent me from participating in the above mentioned activity.
This release contains the entire agreement between the parties to this release and the terms of this release are contractual and not a mere recital.
I acknowledge that all guarantees of horseback riding time are dependent on multiple variables that are out of the control of camp owners, employees, staff, volunteers, and associates. Ride time may be shortened due to inclement weather, horse illness, camper injury/illness, premature camper departure, and ride time may also be deducted as a discipline measure. I understand that Chastain Mist will do everything in its power to provide maximum ride time, but I agree to hold harmless all above mentioned parties in the event that the full amount of ride time isn't completed.
In addition, I realize that many activities offered require a certain amount of study and physical ability by my camper and I give permission to Chastain Mist to assess the ability of my child and decide whether or not he/she may participate. This includes but is not limited to Polo, Jumping, Cantering, and Trotting.
This Waiver and Release Agreement will be construed in accordance with and governed by the laws of the State of WASHINGTON, and it is acknowledged by the Releasor to be as broad and inclusive as permitted by the laws of this jurisdiction.
Check this box if your child can participate in all activities, including off site field trips with Chastain Mist. If box is not checked, child does not have permission to participate.
I HAVE READ AND UNDERSTAND THIS AGREEMENT, AND I AM AWARE THAT BY SIGNING THIS AGREEMENT I AM WAIVING CERTAIN LEGAL RIGHTS WHICH I OR MY HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS AND ASSIGNS MAY HAVE AGAINST THE RELEASEE(S).
I have read and understand the contents of this application, including the Cancelation Policy, Payment Policy and Conditions of Registration. This application has my approval and consent:
The Releasor has executed this Waiver and Release at (City)______________,_______________(County),
WA on the _____day of __________, 20___.
Signature of Releasor ___________________________________
Signature of Camper _____________________________________
We no longer accept checks. Deposits and tuition must be paid online with a credit or debit card, or by sending through Paypal using email address ChastainMist@Gmail.com. Please request an invoice if you do not have paypal.
Registrations need to be scanned and emailed to us. No paper copies will be accepted.