Mommy and Me Camp Registration

Please complete and submit the registration form below to proceed with your purchase.

    MOMMY & ME CAMP AGES 3 & 4 - REGISTRATION FORM

    Camp runs 9:30AM to 11:00AM
    $50.00 PER COUPLE

    Camp date you selected to book:*

    *Note: This form is not a reservation for camp. You cannot select a new date from this form. In order to reserve your spot, you will need to complete your purchase after completing this registration.

    Please note:


    GUARDIANS NAME: AGE:
    CAMPERS NAME: AGE:
    EMAIL:
    ADDRESS:
    PHONE #:

    Emergency Contact:
    Relationship:
    Emergency Contact Phone #:
    Alternate Phone #:

    Physician Name:
    Physician Phone #:

    My child is covered with insurance.
    Policy #
    Group #:
    Insured’s name: .


    Hospital of choice:

    BY SIGNING BELOW YOU:

    • Consent to receiving electronic communications from us.
    • Agree that electronic communications have the same effect as if provided to you on paper.
    • Agree that your electronic signature (via filling in your name below and submitting this form) in connection with agreements and other communications has the same effect as an ink signature.
    • Confirm that you are authorized to provide this consent on behalf of yourself and your child and/or legal ward.

    Parent or Guardian Signature: Date:

    KRAUS FARMS EQUESTRIAN CENTER
    333 HILLSBORO RD. ST. LOUIS, MO. 63049
    (636)225-9513 or visit us at www.krausfarms.com