Individual Boy Scout Registration Form - 2016

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BUCKEYE COUNCIL, INC.
BOY SCOUTS OF AMERICA
SUMMER CAMP 2016
#2
SEVEN RANGES SCOUT RESERVATION
Completing this form "on-line" will make your registration for camp easier…
INDIVIDUAL BOY SCOUT REGISTRATION FORM
District/
Name ________________________________________________
Troop No.
Council
Address ______________________________________________
Current Rank Held
City ____________________________ State ____ Zip _________
Current Pipestone Held
1
2
3
4
5
(Circle One)
Telephone No. (_____)___________________________
Birthdate ______________________
Attending Camp:
____ As a Lone/Provisional Scout
____ As a SPL-2-B Participant
____ With My Unit
(include form #5 - SPL-2-B form)
____ With Unit # _____
____ For a 2nd Week
____ Crossover Scout
Registered with my Council
Yes ____ No ____
Period Camping:
1
2
3
4
5
6
7
(Circle One)
Camp Fees:
Camp Dates:
Camp
Camp
Algonkin
Calumet
In Council Units
Boy Scout
$285.00
$205.00
Period 1
-
06/19 - 06/25
1st Sibling
$275.00
$195.00
Period 2
-
06/26 - 07/02
2nd Sibling
$265.00
$185.00
Period 3
-
07/03 - 07/09
Period 4
-
07/10 - 07/16
Out-of-Council Units
Period 5
-
07/17 - 07/23
Boy Scout
$305.00
$210.00
Period 6
-
07/24 - 07/30
1st Sibling
$295.00
$205.00
Period 7
-
07/31 - 08/06
2nd Sibling
$285.00
$195.00
Each Boy Scout submitting a $50.00 NON-REFUNDABLE deposit by FEBRUARY 15, 2016 ONLINE will receive an "Early Bird" gift.
Each Boy Scout who has paid $100.00 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 $20.00 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 Scout 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
$_________________
Popcorn Certificate
$_________________
Campership Amt
$_________________
NYLT Certificate
$_________________
X:\Program\Camping\Summer Camp\2016\Forms\Individual Boy Scout Registration Form.xlsx
Acct. No. 1-6701-702-21

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