2018 PONY CLUB RESERVATION FORM
Kensington Stables Inc.
51 Caton Place, Brooklyn, NY 11218 Tel: 718-972-4588
www.kensingtonstables.com
RIDER INFORMATION
Name ______Age ______Date of Birth______
Approx. Height______Approx. Weight______Allergies ______
Sibling ______Age ______Date of Birth______
Approx. Height______Approx. Weight______Allergies ______
Address ______
City______State_____ ZIP______Parent email ______
Home Phone ______Work ______Cell ______
Other info you’d like us to know about your child/children:
______
Previous riding experience:
______
EMERGENCY CONTACT
Name______Relationship to Child ______
Daytime phone: ______Cell phone: ______
Check the week(s) you would like your child to participate & circle payment amount:
[ ] Winter Break Week: Feb 20-24 (10:30am-2:30pm) Regular $325 for week or $65 per day
[ ] Spring Break Week: April 10-14 (10am-4pm) Early Reg by March. 15 is $425; Regular $450
Summer Program (10am-4pm)
Weeks 1 and 3-10 rates: Early Reg by March. 15 - $425; Regular after March. 15 - $450
*Week 2 rates (holiday): Early Reg by March. 15 - $360; Regular after Mar. 15 - $380
Inquire about sibling discounts. One day rate is $95/day.
[ ] Summer Week 1: June 25-June 29 [ ] Summer Week 2: July 2-3, 5-7*
[ ] Summer Week 3: July 9-July 13 [ ] Summer Week 4: July 16-July 20
[ ] Summer Week 5: July 23-July 27 [ ] Summer Week 6: July 30-Aug 3
[ ] Summer Week 7: Aug 6-Aug 10 [ ] Summer Week 8: Aug 13-Aug 17
[ ] Summer Week 9: Aug 20-Aug 24 [ ] Summer Week 10: Aug 27-Aug 31
Do you need [ ] early drop off [ ] late pick-up? $15/hour x days______= $______
Early drop off is from 8:30am-10am and late pick up from 4:00-5:30pm. Please specify your needed hours: ______
Would you like to purchase a helmet? If yes, check size & color.
Size: [ ]small [ ]medium [ ]large
Standard colors ($30): [ ]blue [ ]green [ ]black [ ]white [ ]gold [ ]silver [ ]purple
Fashion colors ($35): [ ]blue mist [ ]sunset pink [ ]lavender [ ]bronze [ ]citron
Allow four weeks for ordering, so make your reservation well in advance.
Subtotals: Pony Club Week(s)______+ Drop-off/Pick-up______+ Helmet______=
TOTAL AMOUNT FOR YOUR RESERVATION: $______
Payment method: [ ] Check/money order (mail with form), or [ ] Credit card (mail form and we will call to process your card)