Family Adventure Days 4/11-12 "*" indicates required fields Step 1 of 2 50% Select Session(s) you would like.* April 11-12, 2026 April 11, 2026 (Saturday)ONLY April 12, 2026 (Sunday) ONLY # of Adult Attendees (18 and Up)*ZeroOneTwoThreeFourFive# of Child Attendees (5 through 17)*ZeroOneTwoThreeFourFive# of Child Attendees (4 and Under)*ZeroOneTwoThreeFourFiveOptional-Lunch Provided $10NoneOneTwoThreeFourFiveSixNotesName* First Last Address* Street Address City State / Province / Region ZIP / Postal Code Home Phone*Email 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 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. YOUR APPLICATION WILL NOT BE COMPLETE UNTIL THIS FORM IS SIGNED (BELOW), SUBMITTED (BELOW) AND PAYMENT IS RECEIVED. 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. For Cancellations, email office@campvalleymill.com no sooner than 48 hours before the start of the event. Cancellation within 48 hours of the event will not be eligible for refund.* 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. Name of Signer* First Last