Valley Mill Camp Spring Registration for 2010

 

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

       
Camper's First Name Nickname
Camper's Last Name Birth Date  
grade next Sept School
Street Address City
Zip Code Home Phone
State Parent 1 Work #
Parents Name 1 Parent 2 Work #
Parents Name 2 Parent 2 Cell #
E-mail Parent 1 Cell #
Boy:
Old Camper:
Girl:
New Camper:
 
 
Will Attend: Tuition : $390. per week

Week One

(3/29- 4/2)

 

 

   

 
   

Parent Signature

_____________________

Date:

______________________

Parent Signature

_____________________

Date:

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

Valley Mill Camp15101 Seneca Road, Germantown MD, 20874.