Line It Up Farm

Creating hope and success together…

Summer Camp 2023 Week 4 Registration

Horse Show Camp

2023 Summer Camp Registration Week 4
Weight *
*
Participants Address *
Participants Address
City
State/Province
Zip/Postal

Best way to contact Parent during camp hours (7am-6pm)

In case of an emergency contact:

Camper Information:
Camp runs Monday through Friday 9am – 2pm
Before and after care is available from 7am-9am and 2pm to 6pm for an additional $10 per hour, per child

Summer Camp is open to new or returning students ages 5-18*. Weeks are limited to 12 participants per week. Line it Up will continue to follow all CDC guidelines regarding social distancing and COVID-19.
*We can make accommodations and exceptions on an individual basis. We also have room for a limited number of students who would like to bring their own horses to camp. Additional fees may apply*

Camp Descriptions: Each week will include a daily riding lesson, daily lessons on care and handling of a horse as well as many activities both on and off of the horses.

Week 4 July 17- July 21 Horse Show Camp – All Ages. Campers will learn about horse show attire, etiquette, and different types of show.  All campers will have the opportunity join us on Sunday for our Line it Up Hunter show. Classes are available for all levels of riders. (Additional fees may apply)

T-Shirt Size:
(Free before April 1st 2022)
Additional T-Shirt(s):

$20

Items to Bring to Camp

  • Packed Lunch- Daily
  • Snacks
  • Water/Drinks (we can refill water bottles)
  • Masks and Personal hand sanitizer are recommended
  • Hard soled shoes or sneakers to ride in
  • Long pants for riding
  • Riding Helmet (if they own one, we do have them available on site)
  • Muck boots (if they own them)
  • Sunscreen and bug spray
  • Shorts or change of clothes for non-horse activities
  • Towel (we occasionally play water games)
  • Sandals or flip flops may be worn in areas that there are no horses
Pay in Full Now

$75 deposit. Include $2 fee for online payments. You’ll be redirected to PayPal after form submission.
Payment Type:

Please Fill out our Release Form Below. Only one per camper needed for all summer activities.

Release for *MUST* be filled out for each camper
ONE submission per camper is good for all summer camp weeks and/or volunteer hours.

Standard Release

To include: Activities held at Line It Up, LLC, or for Windy Hollow Farm, Windy Hollow Farm 4H, and Pony Partners.

Community Service and Volunteers only Please check the appropriate box(s). Volunteers/employees 18 years and or older MUST have proof of a current/clear Pennsylvania Child Abuse History Clearance (this is a State Law) before they can attend Volunteer Training. Those doing service/school or community service hours are responsible for keeping a copy of their hours when they leave, Line it Up, LLC will not keep track of your hours.
Maximum upload size: 516MB
Weight *
(Riders over 200lbs will be evaluated on an individual basis)
If participant is under 18, name of parent or legal Guardian: *
Participants Address *
Participants Address
City
State/Province
Zip/Postal
Please enter the same email address to confirm.

Party responsible for payment of lessons or activities held at Line it Up, LLC if other than above persons:

Responsible Party Address
Responsible Party Address
City
State/Province
Zip/Postal

In case of an emergency, for participants under 18 parent/guardian will be called first:

LIABILITY RELEASE

In consideration of accepting (participant’s name) in the riding/educational programs, or any other activities held at Line it Up Farm, Windy Hollow Farm, with Windy Hollow 4-H or Pony Partners, I understand that horses are unpredictable by nature and I voluntarily assume the risks and dangers involved. I hereby, intending to be legally bound, for myself or my minor child, my heirs, executors or administrators, waive and release all claims for damages I may have against Line it Up, LLC, Windy Hollow Farm, or Pony Partners, its Owners, Instructors, Volunteers, Aides and or Employees for any and all injuries and or loses. A non-employee is not covered by Line it Up’s, Windy Hollow Farm, or Pony Partners, insurance or worker’s compensation policy. Respecting the ability of the horses owned and used by Line it Up, Windy Hollow Farm or Pony Partners, riders who are over 200 pounds will be evaluated on an individual basis. Line it Up, LLC, Windy Hollow Farm, Windy Hollow 4-H, and Pony Partners, are not responsible for loss or damage of any personal items ie: helmets, cell phones, etc.

MEDICAL RELEASE

The above student hereby (check one) *
to any medical, dental, or surgical treatment or procedure of an emergency nature that is reasonably necessary to save the life of the person named above or to restore the person to health. I understand that should medical emergency treatment be required, the current insurance information listed here will be provided to the attending clinic or hospital to cover future payment of incurred bills.

HELMET REQUIREMENT & SUGGESTED RIDING ATTIRE

An ASTM-SEI approved helmet is recommended for all Line it Up, LLC participants while mounted and is required while mounted by all riders under the age of 18. I have been advised to wear hard soled shoes and pants in and around the stables and while working with or riding horses, to help prevent horse related injuries. (Open toe shoes are not allowed in the stable area).
Helmet Consent

INSURANCE

The above-named student carries accident/medical insurance: *

PHOTO/SOCIAL MEDIA RELEASE

The above-named student or their parent or Guardian hereby *
Line it Up, LLC, Windy Hollow Farm, Windy Hollow 4-H or Pony Partners the use and reproduce all photographs taken for promotional and or printed materials.

POLICY OF CONFIDENTIALITY

All information including but not limited to, personal, medical, and financial documents are confidential among all participants, volunteers, and staff. Confidentiality is considered one of our most basic responsibilities.

ACCEPTANCE OF POLICIES

I have read, understand and will respect Line it Up, LLC, Windy Hollow Farm, Windy Hollow 4-H, and Pony Partners, policies as they pertain to: The Release of Liability, Photo/Social Media Release and Policy of Confidentiality
Signature of student, parent, guardian or volunteer (must be 18 years of age to sign for yourself)

Addendum to Liability Release – COVID-19

The undersigned, being of legal age or signing in conjunction with a parent or legal guardian, understands and agrees that, due to the COVID-19 (coronavirus) pandemic, that I, and any parent or legal guardian or other person who appears with me, come to Line it Up, LLC, voluntarily and will follow the recommendations of the Center of Disease Control “CDC” and the Governor of PA.

I/We shall wear a mask whenever I/we are inside the barn facility at Line it Up, LLC and when social distancing is not a viable option. I/we shall follow guidelines of social distancing, hand washing and hand sanitizing (as per the recommendation of the Center for Disease Control (“CDC”)) while at Line it Up, LLC and/or facilities owned or controlled by Line it Up, LLC. I/we shall use hand sanitizer and/or wash our hands right before entering inside the barn facility of Line it Up, LLC. I/we agree to follow any and all posted signage regarding safety and COVID-19 at Line it Up,LLC.

I/We acknowledge the restrictions and recommendations set forth by the governor of PA and the CDC and, I/we choose to continue to participate in equine activities held at Line it Up, LLC, use their facilities, horses and/or to receive training or instruction from the agents or employees of Line it Up, LLC.

I/We are fully aware of the risk of injury and dangers inherent in the riding and handling of horses, I am fully aware of the risks of COVID-19, and, hereby elects voluntarily to participate in said activities, and do hereby willingly enter into this Addendum to Release, Waiver & Indemnity Agreement.

In the event I/we become infected with COVID-19, or experience symptoms consistent with any symptoms of COVID-19, I/we agree that I/we will notify an owner of Line it Up, LLC, immediately, and will not come to Line it Up, LLC and/or any facilities either owned or controlled by Line it Up, LLC, until an appropriate quarantine period has passed, or I/we have received a negative COVID-19 test.

I/we specifically agree to waive my/our rights to sue Line it Up, LLC or any of its owners, officers, directors, shareholders, employees, agents, lessors, successors, heirs, and assigns, for any injury, death, loss, or damage caused to me/us and I/we agree to assume all risks inherent in engaging in the activities at Line it Up, LLC during the COVID-19 pandemic. In addition, I/we agree to indemnify, defend and hold harmless Line it Up, LLC, their owners, officers, directors, shareholders, employees, agents, successors, heirs, and assigns from any loss, claim, suit, or judgment resulting from any injury, death, loss or damage sustained or claimed by rider (or rider’s personal representative) as a result of the COVID-19 virus and pandemic, and further to indemnify Line it Up, LLC, their owners, officers, directors, shareholders, employees, agents, successors, heirs, and assigns from any and all costs of defending such claims, including attorneys’ fees.

CAUTION: READ BEFORE SIGNING
(PARENT OR GUARDIAN MUST SIGN IN ADDITION TO RIDER UNDER EIGHTEEN YEARS OF AGE)
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