Adventure Camp- Monday 7/7 – Valley Mill Camper Forms

Cunningham Falls

Campers will arrive to camp on the bus and head out at approximately 9:30 am to Cunningham State Park. After parking, the group will hike to the falls, about 2 miles round trip. The group will then head to the Lake/beach on the property to swim and play before leaving. Campers will arrive back to Valley Mill Camp in time to depart on their regular scheduled bus.

What to pack:

Refillable Water bottle

Packed lunch

Sunscreen & Bug spray

Backpack

Water shoes & good walking shoes

Hat for sun protection

Towel

Swimsuit

A change of clothes in case your child wants to change

Nearest Hospital:

Frederick Health Hospital Emergency Department

400 W 7th St, Frederick, MD 21701

Trip Leaders:

Paul Diallo – 240-340-2871

Elea Breeden (443-517-3513)

Trip location:

Cunningham Falls State Park

14039 Catoctin Hollow Rd.

Thurmont, MD 21788

Name
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To Give Permission:
By signing this form, you give permission to Valley Mill Camp to take your child off camp property to participate in the Adventure Camp Trip. If you would like your camper to attend this trip, make sure to indicate this with your digital signature. If you do not want to give permission or if they cannot attend, or if you have any questions, please call 301-948-0220.
Child's Name*
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Parent's Name
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MEDICAL RESTRICTIONS, AND ANYTHING YOU'D LIKE US TO KNOW
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- My child has no physical, mental or medical condition that would adversely affect his/her ability to participate in the Valley Mill Camp program or that would affect his/her safety or the safety of the group. I agree to inform Valley Mill Camp of any such physical, mental, or medical condition should one develop in the future.
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- I understand and agree that in participating in the Valley Mill Camp program or using the equipment or facilities of Valley Mill Camp or receiving the instruction of Valley Mill Camp there is the possibility of accidental or other physical injury. I agree to assume the risk of such injury and further agree to indemnify Valley Mill Camp Inc., Seneca Joint Venture and all of their agents, employees, directors, officers, affiliates, successors, and assigns (collectively “Valley Mill Camp”) from any and all liability as a result of my or my camper’s use of the facilities, equipment and instruction offered by Valley Mill Camp.
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- 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
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- 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.
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