Mom And Me Form

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Mom and ME
WHAT:
Pack your day pack and get ready for a fun-filled weekend
of archery, BB guns, crafts, games and much, much more!!
All activity supplies will be provided.
WHO:
All Tiger, Wolf, Bear Cubs and Webelos .
Each Scout must bring a Mom (or Aunt, Grandma, etc.)
WHERE:
Camp Pico Blanco, Off Highway 1, South of Carmel
Download the firearm permission form
and the health history/medical form
COST:
$25 - youth by April 1
(parts A and B) and bring to camp for
EACH participant:
$30 - youth by April 15
$40 - youth after April 15
970 West Julian Street
$20 - adult registration at any time
San Jose, CA 95126
$25 - Meal plan per person
Phone: 408-638-8300
Fax: 408-280-5162
IMPORTANT LEADER NOTES
E-mail:
-
Register as an entire Pack or Den
Website:
-
Check-in is from 4:30 PM – 7:00 PM Friday
-
Campsites will be assigned based on the size of your group
Meal Plan Option—$25 Each
-
Cooking must be done as a Pack; kitchen facilities are not
Saturday
available. Use of camp stoves only. No fires allowed!
Breakfast
-
Be prepared for a dirt road in to camp
Lunch
-
Cub Leader BALOO Training not required
Dinner
-
This event is for Cub Scouts only (no siblings or pets)
Sunday
-
Event includes Cracker Barrel (evening snack) on Friday
Breakfast
night
Adult in Charge: ____________________________________________________________________
Address: _______________________________________ City: __________________ Zip: __________
Email: _____________________________________________ Phone: (______) ________ - _________
 Pack #_______ District: _______________
Special dietary needs: _____________________________________________________________________
___ Tigers ___ Wolf/ Bear ___ Webelos 1 & 2 = ____ @ $______ = $ _______
___ Adults (over age of 18) = ____ @ $25= $ _______
___ Meals = ____ @ $25= $ _______
TOTALS:
= $ _______
If paying by credit card: Name on card: _____________________________________________________
Credit card number: ___________ ___________ ___________
___________ Exp: ______ / ______
Amount: $_____________ Signature: __________________________
Reservations are made on a first-come, first-served basis. Bring your own tent and gear. A program outline
and a suggested equipment list will be available on the website. The adult-to-youth ratio for Cub camping is
one-to-four for Webelos, one-to-two for Wolf and Bear Cubs, and one-to-one for Tiger Cubs.
Please notify us in writing at least two weeks prior to the committed date for cancellations. All refunds are subject to a 15%
cancellation fee. No refund will be processed within 1 week of the activity date. The event will be held rain or shine.

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