Summer 2026 Camp Registration
Camper Name
First Name
Last Name
Camper Birthdate
-
Month
-
Day
Year
Campers must be age 6 - 11 during the week they participate in camp.
Please tell us about any disabilities, challenges, or accommodations needed for this camper, if any.
Please tell us about any prior experience with horses this camper may have.
Is the client a current NCTRC client? If an application and medical form dated within the last year are not on file with NCTRC, we will need these completed prior to the date of camp: https://form.jotform.com/212084764325051
Please Select
Yes, this participant is a current client
No, this participant is not yet a client or is a past client and we will complete new paperwork
Is this camper able to manage their own personal hygiene without assistance?
Please Select
No, camper will be accompanied by an assistant.
Yes.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Grownup to Contact
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Camp Weeks
Categories:
All
All
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next
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Camp Week 1 (June 22 - 26)
$300.00
$
300.00
Camp Week 2 (July 13 - 17)
$300.00
$
300.00
Camp Week 3 (July 27 - 31)
$300.00
$
300.00
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Expiration Month
January
February
March
April
May
June
July
August
September
October
November
December
Expiration Month
Expiration Year
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
Expiration Year
Submit
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