Valley Mill Belks (Bobcat+ Elk) Group Overnight 8/15 Girls Overnight Valley Mill Camp Permission Slip Overnight Information: At approximately 4pm, campers will begin their overnight activities. They will enjoy additional camp activities that the group has planned together. Usually this includes swimming and one other activity. Around 6pm campers prepare to have dinner together over the campfire. They sing camp songs eat dinner and s’mores. There will be a night time activity and then campers will get ready to spend the night in the great outdoors. What to bring : On a overnight in addition to what they normally bring to camp, it is helpful for campers to have an extra towel, clothes for the next day, bug lotion, water bottle, flashlight, sleeping bag, pillow, pajamas, two lunches (one for day of Overnight and one for Next Day), a dry set of clothes to change into. Please make sure that any allergies especially food allergies have been reported to the camp. If you are not sure call the main office at 301-948-0220 to speak to the nurse during business hours. To Give Permission for your Child to attend the Overnight : By signing this form you give permission to Valley Mill Camp to have your child participate in the activity listed above. If you would like your camper to participate make sure to indicate this with your digital signature. If you do not want to give permission or if you have any questions please call 301-948-0220. Thank You!!!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.