Welcome To Shekinah Western Ranch
Welcome to our on-line Sign-up Application.
Please provide the information below and click "Send Form" when finished. If we need to contact you for further information we will do so in a timely manor.

Please remember that this application will not be considered complete until we receive your payment within two weeks of submission of online application.

The information in this form is not being sent via a secured Internet connection. If you would rather mail your application in, please go to the Sign-Up page and download the application or call us at 724-483-4343.
Rancher Information
Ranchers begin arriving on Sunday at 4:00 PM and camp ends on Friday at 6:00 PM with our "Ranch Rodeo."
How did you find out about the ranch?
Name (First and Last)
Address 1
Address 2
City
State
Zip Code
Phone
email Address
(we do not share your email address with solicitors)
Name of Insurance Co.
Policy Number
Child lives with
Father's Name
Business Phone
Mother's Name
Business Phone
Guardian's Name
Business Phone
Rancher's Age At
Camp Time
Rancher's Height
Date of Birth
Sex
Sleeping Arrangements
Camp Sessions
Please Select 1st and 2nd Choice
Date
Age
Camp
Choice
June 6 - #1 SHEKINAH FUN FEST / OPEN HOUSE (10am-5pm)
June 14-19
8-16
#2 PIONEER ADVENTURE CAMP
(CO-ED)
June 21-26 8-16
#3 PIONEER ADVENTURE CAMP
(CO-ED)
June 22-27
9-16
#4 FRONTIER TRAILBLAZERS CAMP
(CO-ED)
June 28-July 3
7-11
#5 COWPOKES CAMP
(CO-ED)
July 5-10
7-11
#6 COWPOKES “Mini” CAMP
(CO-ED)
July 12-17
8-16
#7 HORSE CRAZY ALL GIRLS CAMP
(Girls Only)
July 19 – 24
#8 SHEKINAH FRIENDS AND FAMILY WEEK
(CO-ED) *Special Reservation Required*
July 26-31 8-16 #9 DUDE’S CAMP
(Boys Only)
Aug 2-7
 8-16
#10 MUSTANG CAMP
(CO-ED)
Aug 9-14
8-16
#11 PIONEER ADVENTURE CAMP
(CO-ED)
Aug 16-21
8-16
#12 HORSE CRAZY ALL GIRLS
(Girls Only)
please note that all dates and camps are subject to change
Rancher Profile
We are interested in providing the most beneficial summer for your child. In order to accomplish this, we would like to have as much information as possible.
Is there divorce or separation in the family?
Are both parents living?
Is there a step-parent?
Are there brothers or sisters?
Rancher Follow-up Information
Rancher's month of birth? (for birthday cards)
Is there any information you feel our staff should know about your child?
Changes To Registration
If you wish to change your child's registered week to another week, we can do that for no additional charge BEFORE JUNE 1 (Subject To Availability). After that a $10.00 fee assessed for a changed week.
Fee Calculations
Click Here for the Fee Calculator
Fee Information
Fee includes all meals while at camp, housing, use of all recreational equipment and facilities, instruction in activities, and awards.

Fee does not include transportation to and from the ranch and purchases.
View the Conditions of Enrollment
I have read all of this application form, and have viewed the Conditions of Enrollment and I hereby accept these conditions of enrollment.
©2008 Shekinah Western Ranch Camp
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