CAMPER APPLICATION

Camper Name(Required)
Mailing Address(Required)
Date of Birth(Required)
If you answer yes, we will reach out to you separately to discuss.
Each camper receives a free t-shirt.

Parent/Guardian Contact Information

Parent/Guardian 1(Required)
Parent/Guardian 2

CAMPER RIDING ABILITY QUESTIONAIRE & GOALS

This questionnaire is meant to provide us with an understanding of your riding ability and the goals you have with your horse. We ask that campers complete this form with a parent/guardian

Riding Level Descriptions

Beginner - little to no riding experience.

Beginner Plus- new to riding with limited knowledge.

Intermediate - Comfortable around and on the horse.

Intermediate Plus - Comfortable around and on the horse. Can ride the walk, trot and lope/canter.

Advanced - Very comfortable around and on the horse.  Easily able to ride all the gaits and mostly in a collected manner.

Advanced Plus - Very comfortable around and on the horse.  Easily able to ride all the gaits and mostly in a collected manner. Can also perform other movements at a higher level (ie: pivot, side pass, etc.)

What types of riding does the camper traditionally participate in? Check all that apply(Required)
Though we understand this may change before camp, at this time, what horse are you bringing to camp?

EQUINE EMERGENCY

In the case of an emergency with my horse/pony and I cannot be reached, please contact the following person to make decisions for the care of our horse/pony. Moreover, I agree to assume all costs associated with the treatment of the animal. If this information needs to be updated closer to camp, please email camp at info@eihpc.com. If you are not bringing a horse to camp, type your name and/or N/A in any of the required fields below.
Equine Emergency Contact Name(Required)

ELECTIVE SELECTION

Electives are offered Monday through Thursday, from 4:15 to 5:15 pm. These classes range in topics with some requiring you to either ride or be at halter with your horse, while other classes don't require a horse at all!

Please read the descriptions below and choose your top 15 electives - 1 being your first choice, 2 is your second choice, etc.  Please do not repeat your choices. If you pick an elective more than once, we will go to your next choice and/or choose an elective for you. CAMPERS SHOULD COMPLETE THEIR ELECTIVE CHOICES WITH THEIR PARENT/GUARDIAN.

 

ELECTIVE OPTIONS:

  • ARCHERY ON HORSEBACK - Think you have great aim with a bow? How good is it from the back of a horse? Learn about the fun sport of archery on horseback!
  • AUCTIONEERING - Learn the fine art of auctioneering and what it takes to do it! (Non horse class)
  • BARRELS (Beginner) - Basic knowledge of the pattern and how to set up your horse properly to go around the barrels
  • BARRELS (Intermediate & Advanced) - Learn about exercises to use while practicing that will enhance the performance of the rider. For campers that have competed I barrels on a regular basis and clearly understand the basics.
  • BARRELS: STARTING A YOUNG HORSE - Learn about how to start a new horse on barrels; what exercises and drills work best. This class will NOT be running a pattern per se. Its learning the building blocks that make a successful horse.
  • BECOMING A RODEO QUEEN - Interested in becoming a princess or queen for your local saddle club or rodeo? What about Miss Rodeo USA? Learn about what it takes and how to get started! (Non horse class)
  • BLACKSMITHING & HORSESHOE NAIL RING - What does it take to be a blacksmith? What is is like to forge something? You'll learn all that AND make your own horseshoe nail ring in the process! **CAUTION, this elective will require campers to be around a hot forge and tools.** (Non horse class)
  • BLANKET TYING- Get crafty and learn how to make tie blankets!
  • BROOM POLO - Have a blast and play polo on your horse. We'll show you how to first desensitize your horse to the broom and ball as well as the importance of body control. Then its game time!
  • BUYING HORSES - What goes into selecting your next horse? What sorts of things should you look out for? What questions should you ask? What all goes into a prepurchase exam and more! (Non horse class)
  • CAMPFIRE STARTING AND COOKING - Learning how to start a campfire and prepare a delious snack
  • CATTLE WORK - You'll learn how to read cattle and how to effectively work them on your horse.
  • CHIROPRACTIC ARE FOR YOUR HORSE - Learn what all goes into chiropractic adjustments for a horse and why its so important for their performance. (Non horse class)
  • COLIC CARE - Learn the signs of colic, what do do, after care and prevention. (Non horse class)
  • COLT STARTING (2 day elective) - Observe the basics of starting a young horse and using a round pen to the fullest. (Non horse class)
  • COWBOY DRESSAGE - Learn what Cowboy Dressage is and how it can help you and your horse!
  • COWBOY MOUNTED SHOOTING - Learn the ins and outs of cowboy mounted shooting, using NERF GUNS! You'll learn safety, rules and actually get to shoot.
  • DESENSITIZING THE HORSE - Learn how to properly desensitize your horse, tools and approach to use. (At halter class)
  • DRESSAGE - Can be done in an English or western saddle. Learn what dressage is and how it can benefit you and your horse.
  • DRILL TEAM (2 day elective) - Learn basics of what a drill team does and practice a simple routine to be performed on Friday afternoon electives for parents and guests to watch
  • EQUINE BREEDING - Interested in breeding a mare? Learn about the process of equine breeding, genetics, stages of gestation, common complications, and proper mare care. (Non horse class)
  • FLAGS - What is the trick to make that flag stick in the bucket while still going fast to beat the timer? Find out in this class!
  • GOAT TYING - Hands on opportunity to try out goat tying and how it all works (Non horse class)
  • GOAT TYING ON THE HORSE (2 day class) - Hands on opportunity to take your skills to the next level with goat tying. Learn how to be quick and consistent while mastering the dismount from your horse!
  • GROOMING & FITTING FOR COMPETITION - Learn how to properly groom and fit your horse for show. Learn to groom like a pro; clipping, banding, grooming, tricks of the trade. (Non horse class)
  • HORSE JUDGING - Get to know the basics of judging a horse's confirmation in a halter class. (Non horse class)
  • HORSE SOCCER - Have some fun while teaching your horse to not fear an object and become more responsive.
  • JUMPING - Can be done in an English or western saddle. Learn the basics of jumping your horse over small jumps.
  • LEATHERWORK & LEATHER KEYCHAIN - Working leather is an art and you'll learn about the tricks of the trade in this class. PLUS you'll also get the chance to make your own leather keychain! (Non horse class)
  • LIBERTY TRAINING - Learn the basics of what liberty work is with your horse and where to start training. (Non horse class)
  • LINE DANCING - Put on your dancing boots and learn how to do a few dances that you can show off! (Non horse class)
  • MINDFULNESS WITH YOUR HORSE - What is mindfulness and how can it improve your riding and edge in the competition ring. (Non horse class)
  • NO BAKE HORSE TREATS - Learn how to make yummy treats for your horse. (Non horse class)
  • PILLOWCASE MAKING - Get crafty and make a pillowcase in this craft class!
  • POLE BENDING - Basic knowledge of the pattern and how to set up your horse properly to go around the barrels.
  • RANCH HORSE CLASS - What does it mean to be in a Ranch Horse class? How is it different than other classes I've been in? What are they looking for out of me and my horse? Learn all of that here!
  • RANCH RIDING - The horse is judged on its ability to work at a forward and purposeful movement, working speed while performing required and optional maneuvers.
  • REINING - Learn how to read and remember a pattern, how the judging and points work and how ride the pattern. Pick up exercises to take home and work on your spins and stops.
  • ROPE HALTERS - Tie the knot at camp! In this elective, you'll be taught how to make your own rope halter for your horse! (Non horse class)
  • ROPING ON THE GROUND - Learn the basic techniques on how to rope. Great for beginners. (Non horse class)
  • ROPING ON THE HORSE (Intermediate & Advanced) - For those that know how to rope; not for beginners Get to know how to handle your horse and rope a moving object.
  • SHOWMANSHIP (Beginner) - Understand the basics of showmanship. Quadrants, simple pattern, halter fit, and general explanation of fitting the horse. (At halter class)
  • SHOWMANSHIP (Intermediate & Advanced) - Perfect skills of showmanship with more complex patterns. (At halter class)
  • STOPPING AND SUPPLENESS - Having a nice stop on your horse comes with time and patience. Learn how to get your horse to be supple and have a nice stop.
  • THE EQUINE PEDIGREE - Learn how to read a horse's papers, know some common lingo heard and get a snap shot of the major plays in the stock breeds based on the discipline you're riding. (Non horse class)
  • TRAIL & OBSTACLES - Learn how to conquer various types of obstacles such as a bridge, mailbox, water crossing and more.
  • TRICK TRAINING- Learn the steps to take to get your horse to perform a trick (Non horse class)
  • WESTERN PLEASURE (Advanced) - Perfect your skills and your horse's. Learn how to set your horse's head and speed through various exercises
  • YOGA - Learn how yoga can help you stretch out while staying healthy and strong whether its to compete or just ride for fun! (Non horse class)

Waivers and Releases

Please carefully read each statement, release, and waivers below. At the end of each section you'll be asked to check off consent from the camper as well as the parent or guardian. Signatures will be required at the end of all the waivers, statements and releases.

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.

CAMPER CODE OF RESPONSIBILITIES

Your behavior will help to make Horse & Pony Camp a success. The following code outlines your responsibilities.

  • Follow the policies, regulations and requests of the Eastern Iowa Horse & Pony Camp.
  • Aid in maintaining a clean grounds, this includes and not limited to: dorms, dining hall, barns, bathrooms, and arenas.
  • Respect the grounds and property and cause no damage to public and/or private property. If damage is caused, pay for any damages sustained.
  • Will not consume or possess alcoholic beverages, tobacco products, or illegal drugs
  • Will not be in possession of any fireworks, explosives, knives, firearms, or any other type of weapon.
  • Be punctual and active in all lessons, workshops, sessions, activities, ect.
  • Wear appropriate attire and be ready for all lessons, workshops, and other sessions.
  • Treat all those at camp-fellow campers, mentors, staff, volunteers, instructors, board of directors, etc, with respect
  • Not eat or drink in my dorm.
  • Leave/sneak out of the dorm after lights out.
  • Check in all medication with camp nurse at check in.
  • Pay for any damage I have caused to public or private property while at camp.
  • Wear my name tag at all times - if you lose or destroy your name tag, a replacement name tag will be issued and you will be charged $3 for it.

 

Parents, I agree that my child will obey the rules stated. I also agree to pay in full any charges incurred at camp by my child or horse/pony. I have read the Iowa Code Chapter 673, and I am aware of the inherent risks associated with a domesticated animal activity, and take full responsibility for my child, my animal, and my property. I also agree to make no claim against the camp, its organizational committee, The Great Jones County Fairgrounds, or anyone acting on behalf of the camp, for any loss, or injury to any property, person, or animal, resulting from any cause.

RELEASE AND WAIVER OF RIGHT TO SUE AND ASSUMPTION OF RISK

The Equine Activity Liability Release, Waiver of Right to Sue and Assumption of all Risk Agreement (this Agreement) is hereby given by the person signed below (the Undersigned) to the Eastern Iowa Horse and Pony Camp, its organizational committee, the Great Jones County Fairgrounds, the camp staff, Fair Employees, and assigns for the use, the week of camp and on all future dates of the property, facilities or services.

The Undersigned acknowledges that he/she has been advised and does otherwise understand and acknowledge that anything to do with horses, including to but not limited to, riding, competing with, handling, exercising, training or working around them is an inherently dangerous activity AND HEREBY ASSUMES ALL RISKS INHERENT IN EQUINE ACTIVITY.

Being aware of this, and in consideration of the right to participate in any event sponsored by the Eastern Iowa Horse & Pony Camp, the Undersigned hereby acknowledge that the same are safe and suited for the purpose intended.

The Undersigned agrees to accept full responsibility for, and the risk of bodily injury, death, or property damage that he/she may suffer as a result of riding, working at, or participating in any activity sponsored by the Eastern Iowa Horse and Pony Camp.

The Undersigned further hereby RELEASES, agrees to assume all risks, and waives all rights which he/she, his/her children or spouse, if any, heirs, administrators, personal representatives, or assigns may have or hereafter have against the Eastern Iowa Horse & Pony Camp, its organizational committee, volunteers or staff, The Great Jones County Fairgrounds and its Board of Directors, and employees, for death, personal injury, or damage which is in any way associated with any activity sponsored by the Eastern Iowa Horse &  Pony Camp, and hereby Waives the right to sue or bring any action against them.

This agreement is non-assignable and non-transferable and is made and entered into the State of Iowa and shall be enforced and interpreted under the laws of this state.

The Undersigned agrees that he/she and his/her parents or guardians have read this agreement, understand it, and are signing it voluntarily.

ASSUMPTION OF THE RISK AND WAIVER OF LIABILITY RELATING TO CORONAVIRUS/COVID-19

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. The Eastern Iowa Horse & Pony Camp has put in place preventative measures to reduce the spread of COVID-19; however, the Eastern Iowa Horse & Pony Camp cannot guarantee that you will not become infected with COVID-19. Further, participation could increase your risk of contracting COVID-19.

READ CAREFULLY BEFORE SIGNING

By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my camper may be exposed to or infected by COVID-19 by participation; and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at the Eastern Iowa Horse & Pony Camp of the current year of this registration may result from the actions, omissions, or negligence of my mentor/camper and others, including, but not limited to, Eastern Iowa Horse & Pony Camp employees, volunteers, directors, and program participants and their families.

By signing this agreement, I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my mentor/camper (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that they may experience or incur in connection with their participation at The Eastern Iowa Horse & Pony Camp of the current registration year.  On my behalf, I hereby release, covenant not to sue, discharge, and hold harmless the Eastern Iowa Horse & Pony Camp, its employees, agents, volunteers, directors, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of the Eastern Iowa Horse & Pony Camp, its employees, agents, volunteers, directors, and representatives, whether a COVID-19 infection occurs before, during, or after participation at The Eastern Iowa Horse & Pony Camp of the current registration year.

By signing this agreement, I represent that I have adequate insurance to cover any injury or illness my mentor/camper may suffer or cause while participating in this activity, or else I agree to bear the costs of such injury or illness myself. I further represent that my camper has no medical or physical condition which could interfere with their safety in this activity, or else I am willing to assume and bear the costs of all risks that may be created, directly or indirectly, by any such condition.

By signing this document, I agree that if my camper is exposed or infected by COVID-19 during their participation in this activity, then I may be found by a court of law to have waived my right to maintain a lawsuit against the parties being released on the basis of any claim for negligence.

By signing this document, I have had sufficient time to read this entire document and, should I choose to do so, consult with legal counsel prior to signing. Also, I understand that this activity might not be made available to my mentor/camper or that the cost to engage in this activity would be significantly greater if I were to choose not to sign this release, and agree that the opportunity to participate at the stated cost in return for the execution of this release is a reasonable bargain. I have read and understood this document and I agree to be bound by its terms.

By signing this document, if I have signed a separate general waiver of liability connected to my mentor/camper participation at the Eastern Iowa Horse Pony Camp of the current year that is being registered, I agree that the terms of that waiver are wholly incorporated into this document and that the terms of this document are incorporated into the separate general waiver.

By signing this document, in consideration of myself and/or minor being permitted to participate in this activity, I further agree to indemnify and hold harmless releases from any claims alleging negligence which are brought by or on behalf of minor or are in any way connected with such participation by minor. By signing this document, I acknowledge that I have read and understand the Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19 waiver.

MEDIA RELEASE

I, the undersigned, grant permission to the Eastern Iowa Horse and Pony Camp to use photographs, videos, and/or audio recordings of me (or my minor child) for promotional purposes. This includes but is not limited to:

  • Print Media (e.g., brochures, newsletters)
  • Digital Media (e.g., websites, social media platforms)
  • Video Productions
  • Advertising Materials

I understand that these images and recordings may be used without further notice or compensation and will be used solely to promote the activities and events of the Eastern Iowa Horse and Pony Camp.

I release the Eastern Iowa Horse and Pony Camp from any claims, demands, or liabilities associated with the use of these materials.

PRIVATE/PUBLIC TRANSPORTATION CONSENT & RELEASE

At times it becomes necessary to use private or public vehicles to transport campers to and from activities off the campus of the Eastern Iowa Horse & Pony Camp. By signing this form, I hereby release the Eastern Iowa Horse & Pony Camp, as well as its directors, officers, administrators, employees, volunteers, or other agents from all liability or damages for any and all injuries arising from the negligence of any of the above while traveling to offsite activities via public or private transportation. This permission is granted for the current camp year for which is being registered.

CAMPER ELECTRONIC SIGNATURE OF ALL CONSENTS, WAIVERS, AND FORMS

Camper Electronic Signature Authorization By signing electronically, you agree that your electronic signature is the legal equivalent of your manual/handwritten signature. By providing your electronic signature, you confirm that you have read, understand, and agree to the terms and conditions outlined in this waiver.

Camper Name(Required)
Clear Signature

PARENT OR GUARDIAN ELECTRONIC SIGNATURE OF ALL CONSENTS, WAIVERS, AND FORMS

Parent/Guardian Electronic Signature Authorization By signing electronically, you agree that your electronic signature is the legal equivalent of your manual/handwritten signature. By providing your electronic signature, you confirm that you have read, understand, and agree to the terms and conditions outlined in this waiver.

Parent or Guardian Name(Required)
Clear Signature

SUBMISSION OF CAMPER REGISTRATION

What would you like the 2025 Camp theme to be?(Required)
Are there any final comments, notes or things that you need to let the EIHPC Board know about prior to registering your camper?

Payment

The camp registration fee is $550 and is non-refundable.
Payment Method(Required)
American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
 
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