2023 Summer Registration

"*" indicates required fields

Select Session(s)*

At this time, Our Junior Camp (ages 4-5) is on a Waitlist Status for Weeks 6/26 -8/25

Notes

Adventure Camp is a rugged program for our more experienced campers. Adventure Campers will participate in off site activities and 2-3 night overnight trips each week. An additional $100/week fee will be applied. Adventure Camp is open to experienced campers age 11 and up.

My Camper is aged 11 or older, and would like to be considered for Adventure Camp

Camper Name*

First Last

Address*

Street Address City State / Province / Region ZIP / Postal Code

Home Phone*

Gender*

Date of Birth*

Age*

Grade Next September*

School Name*

Has your Camper attended Valley Mill Camp before?*

How did you hear about Valley Mill Camp?*

Buddy Request

T-Shirt Size*

Parent #1*

First Last

Parent #1 Email*

Parent #1 Cell Phone*

Parent #1 Work Phone*

Parent #2 Name

First Last

Parent #2 Email

Parent #2 Cell Phone

Parent #2 Work Phone

Emergency Contact Name*

First Last

Emergency Contact Phone*

Date of Last Tetanus Shot*

Health Information*

Transportation: Valley Mill Camp offers transportation to and from Camp. Please indicate your top 3 choices for Pick Up Points using the drop down menus below.

First Choice

Second Choice

Third Choice

Photo Permission – Valley Mill Staff takes photos of campers to include on our Website, Social Media and occasionally Camp Literature. No Camper is ever identified by Name. Please Click the response below to indicate your preference.*

Yes, I give my permission to use photos including my child on Valley Mill’s Websites, Social Media and Camp Literature

No, I do not give my permission to use photos including my child on Valley Mill’s Websites, Social Media and Camp Literature

Privacy Permission – Is it ok to share your phone number and email with other parents in your child's group for the purpose of party and playdate invitations.*

Yes, I give my permission to share my contact information with other parents

No, I do not give my permission to share my contact information with other parents

YOUR APPLICATION WILL NOT BE CONSIDERED UNTIL THIS FORM IS SIGNED (BELOW), SUBMITTED (BELOW) AND REGISTRATION FEE IS RECEIVED WITHIN 72 HOURS OF YOUR ONLINE SUBMISSION. A CONFIRMATION EMAIL WILL BE SENT TO YOU WITH A COPY OF YOUR APPLICATION, IF YOU DO NOT RECEIVE A CONFIRMATION EMAIL IT IS YOUR RESPONSIBILITY TO REPORT IT TO REGISTRATION@CAMPERFORMS.COM*

By checking here you agree that you have read and understood the statement above.

2023 Refund Policies

Upon registration, the first $50 of your registration fee/tuition is non-refundable to cover the costs of processing, database, and staffing fees associated with registration.*

By checking here you agree that you have read and understood the statement above.

If your family decides to cancel before March 1st, you will receive a refund of any monies paid in for the 2023 Season minus the $50 outlined above.*

By checking here you agree that you have read and understood the statement above.

If your family decides to cancel in full for any reason from March 1st – May 31st, you will receive a refund for any monies paid in for the 2023 Season minus the full registration fee.*

By checking here you agree that you have read and understood the statement above.

If your family decides to partially cancel for any reason from March 1st – May 31st, you will receive a refund for any monies paid in minus the $50 described above and a cancellation fee of $100/week cancelled, up to the full amount of the Registration Fee.*

By checking here you agree that you have read and understood the statement above.

NO REFUNDS WILL BE GIVEN AFTER MAY 31st unless for a verified medical reason (Documentation Required).*

By checking here you agree that you have read and understood the statement above.

Medical Reasons need to be confirmed by a physician in writing and with a recommendation that your camper withdraw from camp. No refund or credit will be made for the first five days of consecutive absence. Non-consecutive days of absence cannot be accumulated for refund. Other than absences of more than 5 consecutive days, verified by a physician, there are no refunds provided.*

By checking here you agree that you have read and understood the statement above.

COVID-19: In the event of mandated closure, Camp initiated quarantine or other exclusion by any governmental agency due to safety concerns with the COVID-19 Pandemic, any tuition or fees paid for the missed days will be credited towards the next year’s Season. No refunds will be provided.*

By checking here you agree that you have read and understood the statement above.

Effective immediately, Valley Mill Camp will no longer issue rollover credits except in the case that your camper is forced to be excluded from camp as outlined above All rollover credits issued during the 2020 and 2021 Seasons will still be honored.*

By checking here you agree that you have read and understood the statement above.

Exchanging Weeks: If a camper is unable to attend one or more weeks in any session, those weeks may be made up in another session, DEPENDING UPON AVAILABILITY. Exchanges made after May 1 will incur a $100.00 per week fee.*

By checking here you agree that you have read and understood the statement above.

I understand that in registering my Camper(s) I am purchasing a spot for the specific dates chosen. There are no "make up days", refunds or credits for days absent, except as outlined above*

By checking here you agree that you have read and understood the statement above.

I understand and agree to abide by all of the policies outlined above.*

By checking here you agree that you have read and understood the statement above.

COVID-19

I agree to monitor my camper(s) for any symptoms related to COVID-19 for a period of at least 2 weeks prior to arriving at Camp, and to report any such symptoms before arriving at Camp.*

By checking here you agree that you have read and understood the statement above.

I have discussed participation in Valley Mill Camp with my camper's Healthcare Provider including considerations related to the risk of COVID-19.*

By checking here you agree that you have read and understood the statement above.

Coronavirus, COVID-19 is an extremely contagious virus that spreads easily through person-to-person contact. Federal and state authorities recommend social distancing as a mean to prevent the spread of the virus. COVID-19 can lead to severe illness, personal injury, permanent disability, and death. Participating in Valley Mill Camp’s programs or accessing Valley Mill Camp’s facilities could increase the risk of contracting COVID-19. Valley Mill Camp in no way warrants that COVID-19 infection will not occur through participation in Valley Mill Camp programs or accessing Valley Mill Camp facilities.*

By checking here you agree that you have read and understood the statement above.

In consideration of my camper's participation in Valley Mill Camp I agree to release and on behalf of myself, my heirs, representatives, executors, administrators, and assigns, HEREBY DO RELEASE Valley Mill Camp, its officers, directors, employees, volunteers, agents, representatives and insurers (“Releasees”) from any causes of action, claims, or demands of any nature whatsoever including, but in no way limited to, claims of negligence, which I, my heirs, representatives, executors, administrators and assigns may have, now or in the future, against Valley Mill Camp on account of personal injury, property damage, death or accident of any kind, arising out of or in any way related to the use of Valley Mill Camp facilities/equipment or participation in Valley Mill Camp programs whether that participation is supervised or unsupervised, however the injury or damage occurs, including, but not limited to the negligence of Releasees.*

By checking here you agree that you have read and understood the statement above.

In consideration of my camper's participation in Valley Mill Camp, I, the undersigned participant, agree to INDEMNIFY AND HOLD HARMLESS Releasees from any and all causes of action, claims, demands, losses, or costs of any nature whatsoever arising out of or in any way related to my camper's Valley Mill Camp participation.*

By checking here you agree that you have read and understood the statement above.

I hereby certify that I have full knowledge of the nature and extent of the risks inherent in Valley Mill Camp participation and that I am voluntarily assuming said risks. I understand that I will be solely responsible for any loss or damage, including personal injury, property damage, or death, I sustain while participating in Valley Mill Camp and that by signing this agreement I HEREBY RELEASE Releasees from all liability for such loss, damage, or death. I further certify that my camper is in good health and that he/she has no conditions or impairments which would preclude safe participation in Valley Mill Camp.*

By checking here you agree that you have read and understood the statement above.

Electronic Signature Agreement*

By checking the above checkbox, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.

I agree that I am the Parent or Legal Guardian of the Camper named above, that I am 18 years of age or older, and that I have the legal authority to grant this permission to Valley Mill Camp Inc.*

By checking here you agree that you have read and understood the statement above.

Name of Signer – Parent or Legal Guardian*

First Last