2017 Cub Scout Summer Camp Registra on, Page 1
Please read prior to registering: A Minimum adult to youth ra o at all of our Cub Camps is 1:4. We achieve this by
packs providing an adult chaperone each day of camp per every four boys a ending camp OR one adult volunteering
two days per registered cub scout at our day camps. If you are registering outside of your pack, an adult must a end at
least two days of camp with your cub scout’s registra on. All parents must a end the pre‐camp orienta on held prior
to camp. For details and frequently asked ques ons (FAQ)
Cub Scout’s Name:____________________________________________________________________________
Adult A ending Camp Name: ___________________________________________________________________
Adult days a ending camp: Monday Tuesday Wednesday Thursday Friday Resident Camp
Address: ___________________________________________________________________________________
City: _________________________________ Zip: ____________ Phone: (________) ________ ‐ __________
Email: __________________________________________________ Pack #__________District:_____________
Youth Grade in Fall 2017: 1st 2nd 3rd 4th 5th
Program level in Fall 2017: Tiger Wolf Bear Webelos 1 Arrow of Light (previously Webelos 2)
Youth small Youth medium
Cub’s T‐Shirt size (one shirt included, addi onal shirts available for $10 purchase
:
)
Youth large Youth XL Adult small Adult medium Adult large Adult XL Adult 2XL Adult 3XL Adult 4XL
Chenoa, June 12‐15, 10‐5
Fort Benito, June 12‐16, M‐Th 10‐4 and F 11‐5
Lake Cunningham #1, June 19,‐23 8:30‐4 Lake Cunningham #2: July 17‐21, 8:30‐4
Morgan Hill, June 12‐16 (5‐day), 8:30‐4 ‐ Morgan Hill One Day, June 10, 10‐5
King City, June 12‐16, 9‐3
Stevens Creek #1, July 10‐14, 8:30‐3 ‐‐‐‐‐ Stevens Creek #2, July 24‐28, 8:30‐3
Towaba, June 26‐30, 9‐4‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ Towaba Webelos Overnight (1‐night): Jun 30‐Jul 1, 4‐11
Toro Park, June 19‐13, 9‐3
Vasona, June 26,‐30 8:30‐3:30
Webelos Resident #1, June 8‐11 4 PM ‐‐‐‐ Webelos Resident #2, June 15‐18 4 PM
Firearms Authoriza on Form
PARENTAL FIREARM AUTHORIZATION FORM, CONSENT OF MINOR TO USE FIREARMS, AMMUNITION, AND B.B. DEVICES*
THIS DOCUMENT AUTHORIZES PARTICIPATION BY A MINOR IN CERTAIN ACTIVITIES.
DO NOT COMPLETE THIS FORM UNLESS YOU WISH YOUR CHILD TO PARTICIPATE IN THESE ACTIVITIES.
I, the undersigned custodial parent or legal guardian of __________________________________________, a minor, do
hereby authorize the Silicon Valley Monterey Bay Council to furnish firearms, muzzle loading rifle, ammuni on, and B.B.
devices, as appropriate*, to the minor named herein for the purpose of instruc on in the safe handling and shoo ng of
firearms, target shoo ng, and related ac vi es under the supervision of the shoo ng sports director, range master, or
range staff.
I do further agree to indemnify and hold harmless the Boy Scouts of America, the Silicon Valley Monterey Bay Council, its
chartered organiza ons, and all officers, members, employees, and volunteers thereof, from all suits or ac ons brought
for, or on account of, any injuries or damages received or sustained by any person or persons by or from the consequenc‐
es of any negligence or any act or omission of the above named minor occurring during the course of said instruc on.
This authoriza on will remain in effect for said minor while par cipa ng in any Boy Scouts of America program or related
ac vity related to firearms, ammuni on, and B.B. devices unless revoked in wri ng by the undersigned and said revoca‐
on is personally delivered to the Silicon Valley Monterey Bay Council.
Parent’s name: ______________________________________
Date: ____________________
Parent’s signature: _________________________________________________________________________________
* The State of California has enacted legislation that requires the consent of a minor’s parent or guardian before a firearm, live ammunition
or B.B. devices may be furnished to the minor for the purpose of instruction in the safe handling and shooting of guns and related activities.
Phone: 408-638-8300
970 West Julian Street
E-mail:
Fax: 408-280-5162
San Jose, CA 95126
Website: