SARABANDE

Summer Camp Registration/Information

Please complete this form & return with $150 non-

refundable deposit to:
Sarabande Academy of Riding-
3250 E. Allen Rd. Tucson, AZ 85718

Student Name __________________________________

Date of Birth ___________________________________

Address _______________________________Zip _______

Home Phone # __________________________________

Parent Name(s) __________________________________

Parent Contact Phone #(s) __________________________

Email Address ___________________________________

Emergency Contact Name __________________________

Emergency Contact Phone #(s) ______________________

Allergies or any important medical information:

Camp Dates: (please circle which session(s) your child will be attending)

Session 1: June6 - June 10 Session 2: June 13 -June 17

Session 3: June 27- July 1 Session 4: July 4 -July 7

Session 5: July11-July114

3250 E. Allen Rd Tucson, AZ 85718 T: (520)907-3965

www.sarabandeacademy.com

info@sarabandeacademy.com