1 Spring Registration

Valley Mill Camp Spring Break Registration for Spring 2008

After Filling Out this form, print it, submit it, sign it and mail it to: 15101 Seneca Rd, Germantown, MD 20874 

Camper's First 

 Name Nickname

Camper's Last 

 Name Birth Date  

Street Address

 School

City

 grade

Zip Code

 Home Phone

State

 Dad Work #

Parents Name 1

 Mom Work #

Parents Name 2

 Mom's Cell #

E-mail

 Dad's Cell #

Old Camper:

New Camper:

Boy:

 Girl:

Week 1  

 ( 3/24 -  3/28/08 )

Tuition : $390.00

Week 2 

( 4/21 - 4/ 25/ 08 ) Tuition : $390.00

 
   
   
Parent Signature ___________________________ Date: _____________________

Parent Signature

 ___________________________

Date:

 _____________________

After Filling Out this form (1) print it, (2) submit it, (3) sign it and (4) mail it to:

Valley Mill Camp 15101 Seneca Road Germantown, MD 20874