Individual Leader Registration Form - 2016
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1BUCKEYE COUNCIL, INC.
BOY SCOUTS OF AMERICA
SUMMER CAMP 2016
#3
SEVEN RANGES SCOUT RESERVATION
Completing this form "on-line" will make your registration for camp easier…
Completing this form "on-line" will make your registration for camp easier…
Completing this form "on-line" will make your registration for camp easier…
Completing this form "on-line" will make your registration for camp easier…
INDIVIDUAL LEADER REGISTRATION FORM
District/
Name ________________________________________________
Troop No.
Council
Address ______________________________________________
Current Leadership Position
City ____________________________ State ____ Zip _________
Current Pipestone Held
1
2
3
4
5
(Circle One)
Telephone No. (_____)___________________________
Email ________________________________
Registered with my Council
Yes ____ No ____
Period Camping:
1
2
3
4
5
6
7
(Circle One)
Camp Fees:
Camp Dates:
All registered leaders (In Council or Out-of-Council) pay
Period 1
-
June 14 to June 20
$130.00 when camping in Camp Algonkin and $75.00 when
Period 2
-
June 21 to June 27
camping in Camp Calumet.
Period 3
-
June 28 to July 4
Period 4
-
July 5 to July 11
Those leaders who choose to camp for only a portion of
Period 5
-
July 12 to July 18
the week will be charged $20 per day/night in Camp
Period 6
-
July 19 to July 25
Algonkin and $12.00 per day/night in Camp Calumet. Please
Period 7
-
July 26 to August 1
indicate the days/nights you anticipate being in camp.
Sunday ______ Monday ______ Tuesday ______ Wednesday ______ Thursday ______ Friday ______
Each Leader submitting a $40.00 NON-REFUNDABLE deposit by FEBRUARY 15, 2016 ONLINE will receive an "Early Bird" gift.
Each Leader who has paid $60.00 by MARCH 15, 2016 ONLINE AND is PAID IN FULL no later than APRIL 15 ONLINE
(If camping in Periods 1, 2, 3 or 4) or MAY 15 ONLINE (If camping in Periods 5, 6 or 7), will receive a $5.00 discount.
All activities offered by The Buckeye Council, require significant planning and purchasing of materials well in advance, which are
provided as part of the program fee. When an individual or unit makes a reservation, the expenses related to that event are incurred to
support that reservation. Therefore a $50.00 non-refundable charge applies. If for any reason a Leader is unable to attend camp, please
refer to Form #6 - Buckeye Council Refund Request Form regarding the Refund Policy.
ALL CAMP FEES MUST BE PAID NO LATER THAN TEN (10) DAYS PRIOR TO ATTENDING CAMP.
Payment Amount
$_________________
Acct. No. 1-6701-702-21
X:\Program\Camping\Summer Camp\2016\Forms\Individual LEADER Registration Form.xlsx
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