June 18th - June 24th, 2023

Held at the Great Jones County Fairgrounds

Monticello, IA

*Camp registration fee is $550.

*Campers must bring a well broke horse or pony, older than 4 years of age, to camp.

*Potential campers must be in at least third grade as of 2/1/23.

You can only submit one child's camp information per form. Sorry for any inconvenience this may cause. The form will not work properly with multiple kids entered on one form.

Camper Information

Camper First Name (Preferred Name) *

Camper Last Name *

Mailing Address *

City *

State *

Zipcode *

COUNTY - Not Country *

Gender *

Current Grade as of 2/1/23 *

Date of Birth (MM/DD/YYYY) *

Camper Cell #

CAMPER'S EMAIL ADDRESS - if they have one and you care to provide it.
(Not the Parent's Email Address.)

Parent/Guardian Contact Information

Parent/Guardian 1 (First and Last Name) *

Relationship to Participant: *

Mother

Father

Guardian

Other Other

Prefer Cell Phone # *

Parent/Guardian's Email Address - Email is our main point of contact. *

Parent/Guardian 2 (First and Last Name)

Relationship to Participant:

Mother

Father

Guardian

Other Other

Prefer Cell Phone #

Parent/Guardian's Second Email Address *** (If different from the first parent/guardian's email address )

Camper Riding Information

Have you ever been to EIHPC before? *

Yes

No

If Yes, how many years have you attended EIHPC?

Iowa Code Chapter 673

WARNING: Under Iowa law, a domesticated animal professional is not liable for damages suffered by, an injury to, or the death of a participant resulting from the inherent risks of domesticated animal activities, pursuant to Iowa Code Chapter 673. You are assuming inherent risks of participating in this domesticated animal activity. A number of inherent risks are associated with a domesticated animal activity. A domesticated animal may behave in a manner that results in damage to property or an injury or death to a person. Risks associated with the activity may include injuries caused by bucking, biting, stumbling, rearing, trampling, scratching, falling, or butting. The domesticated animal may react unpredictably to conditions, including, but not limited to, a sudden movement, loud noise, and unfamiliar environment, or the introduction of unfamiliar persons, animals, or objects. The domesticated animal may also react in a dangerous manner when a condition or treatment is considered hazardous to the welfare of the animal; a collision occurs with an object or animal; or a participant fails to exercise reasonable care, take adequate precautions, or use adequate control when engaging in a domesticated animal activity, including failing to maintain reasonable control of the animal or failing to act in a manner consistent with the person’s abilities.

PARENTS: Please type your first and last name to confirm that you have read and understand this agreement. *

Check the box below. *

I agree that my electronic signature is the legally binding equivalent to my handwritten signature. By my electronic signature, I acknowledge that I have carefully reviewed this Agreement and understand its contents.

Camper Code of Conduct

Any camper may be sent home for any of the following reasons:

Leaving the grounds without camp staff permission
Leaving the dorm units after curfew without permission
Possession and/or use of alcoholic beverages or other drugs
Possession and/or use of tobacco (smoking, vaping, or chewing)
Switching stalls without permission
Causing intentional damage to public or private property - camper will be charged for repairs
Inappropriate conduct at camp (violence, harassment, abuse, threatening, bullying, harmful behavior, etc.)
Possession of weapons, knives, or other dangerous objects
Possession of a cell phone. If a camper needs to call home, they are welcome to use one of the board member’s cell phones. If a parent needs to contact their camper, please call Katie, Ben, Sue, Jesscia, Michael, Matt, Jason or Nick.
Disrespectful behavior to other campers, volunteers, or board members.

Any camper sent home for any of the above reasons will receive no refund, whole or part, and will not be considered for camp next year.

We, the parent(s) and camper, have read and agree to abide by the rules and conditions as stated above. The above named prospective camper has permission to take part in the Eastern Iowa Horse and Pony Camp. We understand that applicant acceptance makes the registration fee non-refundable except in the instance of camp cancellation, in which case your money will be refunded.

*

By checking this box, the camper agrees to abide by these rules and can be asked to leave at anytime.

By checking this box, the parents agree to these rules and recognize a camper can be asked to leave at anytime.

Volunteering at Camp

In order for us to operate a 24-hour-a-day camp for one week at such a low fee, our camp relies HEAVILY on volunteer help. If your schedule permits, you can sign up to volunteer during the week, on Sunday evening, or on Saturday morning. You will need to complete the EIHPC Volunteer Form, found on our website www.eihpc.com, indicating your preferences and availablility. The volunteer form will open on Feb. 1st and close on Mar. 1st.

The success of this camp is directly attributed to the many volunteers we rely on.

THANK YOU!!!

Camp Apparel

If you are interested in purchasing any additional camp apparel, the form will open around March 1st.

You will need to complete the Camp Apparel Order Form found on our website, www.eihpc.com.

Camp Registration Fee

The camp registration fee is $550 and non-refundable. You must check this box. *

Camp Fee - $550

Camp T-Shirt

One camp t-shirt is included with camp registration. Please indicate which size your camper would like for their camp t-shirt. *

Total Fees

Hit the Calculate button below.

Note: The camper application will not be considered accepted until the registration fee is paid in full. If you want to secure a spot for your child, you must pay by credit card, Venmo, or PayPal on the next page.

Grand Total:

$0.00

To Submit Form

In order to submit this application, you must hit next.

On the next page when you are reviewing your order, you must select the payment method to complete the form submission.