Faulkner’s Pony Camp Enrollment 2019

Faulkner’s Ranch • 816.761.5055

Camper Information:


Contact Information

This consent gives permission for medical care in parental absence and must be presented upon admission for treatment. Every effort will be made to notify the parent or guardian immediately in case of emergency, illness, or injury. In the event that the parent cannot be contacted or arrive at Faulkner’s Ranch in ample time, the child will be transported by Ambulance in an emergency situation. In a non-emergency situation the child will remain at Faulkner’s Ranch until a parent or guardian can arrive.

In the event that my child requires medical or surgical care while I am unable to be reached, I hereby give my consent to medical or surgical treatment.

Insurance Information

In case of an Emergency and guardian can not be reached, notify: (someone other than yourself)

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