Southern Winds Equestrian Camp 2013 Registration Form

Camper's Name:

Camper's Age:







Home #:


Cell #:


Work #:

Work # Extension:



Camper's Riding Level:  

Beginner (little or no riding experience or lacks confidence)
Novice (can ride gentle horse at a walk and slow trot)
Intermediate (can walk, trot, canter, needing improvement)
Advanced (previous experience and instruction, good form and control)


Camp Dates: June 23rd - 28th  

Drop off is 4:00pm Sunday June 23rd and pick up is 12:00pm Friday June 28th. All owners with private horses must provide their own transportation. Timely pickup and drop off is expected.

Tuition: $500.00 per camper. $100.00 due at registration, balance due no later than May 22nd, 2013. No registration is accepted without deposit. Make checks payable to: Southern Winds Equestrian Camp

Southern Winds Equestrian Camp T-Shirt
Each child will receive a Camp T-Shirt. Please provide your child’s size, below:

Child's S M L  
  Adult's S M L  


Medical Information:  

Child’s Doctor:


Dr. contact #:


Choice of Hospital:


Please list all
drug allergies:

Daily Medications and dose/s:

Please list all
food allergies:

* A copy of your child's insurance card/s must be emailed with each entry form.


Back to Southern Winds Equestrian Camp Page
Back to Broxton Bridge Plantation Home Page

If you are providing a private horse, you must also fill out the private horse registration form. You will also need to print, sign and send the 'Release and Hold Harmless' waiver, send in a copy of your child's insurance card, and read and understand the Camp Rules & Regulations and Camp Checklist.

For more information or questions call or contact:

Southern Winds Equestrian Camp • 129 Ducane Street • Summerville, SC 29483
Lindsey Loppnow 843-452-0887 /

Sponsored By: Southern Winds Equestrian Camp, Medicine Wind Stables & Broxton Bridge Plantation