Your Name* First Last
2024 Valleybrook Member?* Camper Name* First Last
Birthday Camper Is* Address* Mother/Parent 1 Name* First Last
Father/Parent 2 Name First Last
Please list below the full name and cell phone number of all person(s) authorized to pickup your child (in addition to parent/guardian listed above).
Authorized Person Name First Last
2024 Summer Camp Session Dates* 2024 Before/After Care (B/A) Needed (additional cost): Comments and/or Special Requests
Terms Of Enrollment Agreement* 1. ALL DEPOSITS & FEES ARE NON-REFUNDABLE. NO REFUNDS OR CREDITS WILL BE MADE FOR ABSENCES, ILLNESSES, SUSPENSIONS, DISMISSALS OR CANCELLATIONS. 2. The camper and parents/guardians agree to abide by the rules and regulations set by the Director(s) for the health, safety, and welfare of the campers. 3. Participants who are unable to follow the rules may be asked not to continue their session or not to return in the future and will not be provided a refund. 4. The Director or other authorized staff reserves the right to deny, cancel, sever or suspend a child’s enrollment if deemed for the best interest of the camper, the camp or the club with no refund. 5. Campers must be between the ages of 6 to 15 years old and entering grades 1 through 8 to attend camp. (The camper must have completed kindergarten.) 6. All forms, including a Health History form, Immunization Record and Medication forms must be submitted no later than June 1. 7. It’s All Fun & Games, LLC and Valleybrook Country Club, LLC are not responsible for the camper’s equipment or personal belongings, while in transit or at camp, if lost, stolen or damaged by theft, fire, or otherwise. Do not bring personal items from home. 8. Camp dates subject to change with advance notice. 9. Camp will be closed on weekends, weeknights and the July 4th holiday week. 10. Your child will be provided with a limited Daycamp Membership at Valleybrook Country Club. Daycamp Membership offers the camper the use of the facility only during camp hours and only under the direction of camp staff. Camper may use facility only during weeks for which they have paid. Daycamp membership offers the camper to use the facility during designated hours and does not entitle any other member of family to use the facility at any time. 11. I consent to emergency medical care for my child. 12. I consent to have my child transported on field trips. 13. I give permission for my child to participate in special programs and activities including field trips and other camp related activities. 14. I give permission for my child to be videotaped, photographed, and interviewed for broadcast or publication for promotional purposes. I understand that It’s All Fun & Games, LLC and Valleybrook Country Club, LLC will exercise discretion regarding media contact. 15. I am responsible for any medical costs incurred by my child while enrolled in the camp. I assume sole responsibility of any first aid treatment sought and received from It’s All Fun & Games, LLC and Valleybrook Country Club, LLC including, but not limited to, allergic reaction to first aid and remedies rendered. You must provide all necessary medications and/or allergic reaction medications for bee stings, food allergies, asthma, etc. 16. I am responsible for the cost of repairing or replacing any property that my child damages while attending It’s All Fun & Games, LLC, at Valleybrook Country Club, LLC, or while being transported to or from, or during any off-premise trip. 17. ANY CHANGES FOR SESSIONS MUST BE MADE IN WRITING & SUBMITTED TO THE OFFICE WITH A $25 ADMINISTRATIVE FEE PER CHANGE, PER CHILD. ALL CHANGES ARE SUBJECT TO AVAILABILITY. No changes in sessions will be made for absences, illnesses, suspensions or dismissals. 18. There will be a $50 fee for any checks returned for insufficient funds. Full amount of check plus the $50 fee is due in cash immediately upon notice. LIABILITY, ASSUMPTION OF RISK, INDEMNIFICATION AND RELEASE Liability: Each member of Valleybrook Country Club, LLC (”the club”) and/or It’s All Fun & Games, LLC (”the camp”) shall be personally liable for any personal injury caused by the member, member’s family or member’s guest which damage or injury occurs at the club or the camp, or at any of its pools, apparatus, equipment, facilities or programs. The member shall promptly pay the club for any property damage after presentation of statement. Assumption of Risk: The use of the swimming pools, any apparatus, equipment, facilities or services, owned and operated by the club, the camp, or The Kings at Valleybrook, LLLP is undertaken by the member, member’s family or guests AT SUCH PERSON’S OWN RISK, and the club and the camp shall not be liable for any injuries, death or damages to any such person, to the property of such person, or be subject to any claims, demands or damages resulting from such use. Each member agrees to and does knowingly waive the right to trial by jury in any dispute between the member, the member’s personal representatives, successors or assigns. Indemnification: Each member agrees to indemnify, hold the club or the camp or The Kings at Valleybrook, LLLP, its agents and employees, free and harmless from all damage, suits, liability, costs and expenses incurred in connection with the use of the swimming pools, any apparatus, equipment, facilities and services of the club and camp. Release: Each member hereby releases the club and the camp and The Kings at Valleybrook, LLLP from all damage, suits, liability, costs and expenses incurred in connection with the use of the swimming pools, any apparatus, equipment, facilities, and services of the club and the camp. Binding Effect: The above provisions are binding upon the member, the member‘s personal representatives, successors or assigns. Updated March 2024
Terms Of Enrollment Agreement*