Raccoon Hike & River Safety 8/6 Girls Camp Hike and River Safety Valley Mill Camp Permission Slip Trip Information Valley Mill Camp heads out for a Hike and River Safety trip. The group will leave camp around 10:00 a.m. and arrive near Berryville Road at Seneca Creek Park between 10:10 and 10:20 a.m. The campers are then given a pre-trip safety talk, and then begin the Hike and River Safety Activities. Campers return to camp around 3:15 p.m. What to Bring: Out on the river and while hiking, campers will be exposed to a lot of sun. Make sure to pack sunscreen, hat, sunglasses and anything else that may help protect form the sun. Campers will also get very wet and must wear swimsuit and clothes that are able to go in the river. Please pack lunches that will not spoil since lunches are not refrigerated. Add a soft cold pack to the lunch to keep it cool. Pack lunches in a ziplock bag or otherwise waterproof/water resistant bag. Items good to have on the trip are water bottle, water shoes that will not fall off (required), swimsuit, towel, bag lunch and sun protection. 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 trip listed above. 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.Select Your Child's Group*Select Your Child's GroupCricketsChipmunksSquirrelsBeaversRaccoonsFoxesOttersBobcatsElksLadybugsSongbirds"Belks"Child's Name* First Last Parent's Name First Last Parent's Email Parent's PhoneEmergency Contact Name* First Last Emergency Contact Phone*MEDICAL RESTRICTIONS, AND ANYTHING YOU'D LIKE US TO KNOW* 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. * 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 use of the facilities, equipment and instruction offered by Valley Mill Camp. * 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 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. Type Name of Signer* First Last Date* Date Format: MM slash DD slash YYYY NameThis field is for validation purposes and should be left unchanged.