Summer Camp Registration Form

Summer Camp Registration Form

Please select the weeks your child will attend. A separate form must be completed for each child.
Our Summer Camp at Kids Club at The Mill is all about keeping kids busy, creative, and having fun! Each week features a new exciting theme with themed crafts, games, sensory activities, and hands-on learning experiences. Campers will enjoy weekly walking trips to Sportswall, indoor obstacle courses, movement activities, and special Fun Fridays with pajamas, movies, and popcorn. We may not have outdoor play, but we make every day active, engaging, and full of summer fun!
Camper's Full Name

First NameLast Name
Child's Date of Birth

MonthDayYear
Parent or Guardian Full Name

First NameLast Name
Parent or Guardian Email Address
example@example.com
Parent or Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Which weeks would you like to register for?
We’re excited to offer a weekly Thursday field trip to SportWall from 12:30–1:00 PM!

At SportWall, children will have the opportunity to safely burn energy through active play in a fun, structured environment designed for movement, coordination, and social interaction. Our staff will be present at all times, providing close supervision and ensuring all students are supported and accounted for throughout the visit.

This is a great mid-day outing to help kids stay active, engaged, and excited about their week!

Field trip fee is $10. This fee covers one field trip day for one child.

Sign Up Here:

https://pci.jotform.com/form/261346815462055
How did you find us?
Social Media & Promotional Use: I give permission for Kids Club at The Mill to use photos and/or videos of my child for advertising, publicity, and social media.
Brightwheel Daily Updates: I give permission for Kids Club at The Mill to include photos of my child in daily activity reports shared through Brightwheel (including individual and group photos).
Parent Agreement: I understand that I may receive photos that include other children. I agree not to share, post, or distribute any photos or videos that include children other than my own on social media or in any public format.
Additional Comments or Special Requests
I authorize Kids Club at The Mill to obtain emergency medical treatment for my child if I cannot be reached in the event of an accident, injury, or illness. I understand that every reasonable effort will be made to contact me first and that I am responsible for any medical expenses incurred.
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Week 2: June 22-26

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