Mini Camp Entry Form

Thursday 14th to Saturday 16th August

         Your details:

Name	Age 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Horse or Pony Name	Height > 10 hh 10 hh 10.1 hh 10.2 hh 10.3 hh 11 hh 11.1 hh 11.2 hh 11.3 hh 12 h 12.1 hh 12.2 hh 12.3 hh 13 hh 13.1 hh 13.2 hh 13.3 hh 14 hh 14.1 hh 14.2 hh 14.3 hh 15 hh 15.1 hh 15.2 hh 15.3 hh 16 hh 16.1 hh 16.2 hh 16.3 hh 17 hh < 17 hh Age 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Address
Postcode
Telephone Number (Home)	Mobile

email address

Lead Rein

Off Lead Rein On lead rein

Please state any tests passed.

Any additional information we may need:
Please state any medical conditions or allergies to this member and state any current medications

Please print and post this form along with with a cheque for £55 made payable to:
The Burghley Branch of the Pony Club.
Please write member's name and 'Mini Camp' on reverse of cheque. Places cannot be reserved without payment.

Please send by 1st August  2007 to:
Mrs Cate Goodwin, Walnut Tree Farmhouse,
Church Street, Easton on the Hill Stamford
PE9 3LL