Council Properties Reservation Form

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Northeast Georgia Council
Boy Scouts of America
Fax: 706.693.4849
phone: 706.693.2446
Council Properties
Reservation Form
Reservations must be made no more than 6 months prior and no later than two weeks before the date of your visit.
This form is to be filled out and returned to the Jefferson Service Center. Confirmation will be returned upon approval.
Please allow five days for approval.
Property Request: (circle one)
Camp Rainey Mountain
Rotary
Scoutland
Unit Type/Number: _______________ District: ____________________________ Council: ________________________
Leader in Charge: ____________________________________ email: __________________________________________
Address: ____________________________________________ day/cell: (_________)_____________________________
City: ________________________ ST: ___________ Zip ______________ Fax: (_________)_________________________
Total number attending: ______________ Date(s) requested: from:_____________________ to: _____________________
Does your unit have insurance? ( ) yes ( ) no
Company: ____________________ Policy no: __________________
Campsite Preference: 1) _______________________________________
_____Approved
_____Not Approved
2) _______________________________________
_____Approved
_____Not Approved
Other Facilities
___________________________________________
_____Approved
_____Not Approved
___________________________________________
_____Approved
_____Not Approved
___________________________________________
_____Approved
_____Not Approved
Loan Agreement:
The above unit and its leadership agree to be responsible for the equipment and facilities owned and approved for use by the Northeast Georgia
Council, Boy Scouts of America (the Council). The leadership of this unit will agree to repay or reimburse the Council for damages or loss as a result of
misuse by the scouts, family members or leadership of the unit.
This request acknowledgement will list what site/facilities that you requested, but these items will not be “guaranteed”.
The Ranger or Camp Master will make the final assignment.
I have read and understand the rules and regulations for use of council properties on Page 2 of this document:
_____ (intial)
$50 Cleaning deposit for ALL UNITS is required. Valid credit card information is required for all reservations.
Refunds only upon Ranger/Camp Master inspection.
Credit Card: circle one
Visa
Mastercard
Discover
Card Number: _______________________________________________________ exp date: _______________________
Signature: __________________________________________________________ date: __________________________
Use Fees:
Fees must be paid before confirmation will be sent.
Site fee: Out of Council fee for use is $3.00 per person, per day ($75.00 minimum per group, per day)
Estimated attendance ________________ X Number of Days _____ X $3.00 = Total site fee due:
$__________________
There is no site fee for In Council troops to reserve a campsite
Canoes/Rowboats: $10.00 per boat, per day, first come-first served.
Total boat fees due:
$__________________
Only Boy Scout aged youth and older may request boats (No Cub Scout Units)
Additional fees apply for use of Family Cabins ($75 per night), Staff Area Cabins ($25 per night), and Directors Cabin facilities ($75 per night).
Please call for availability and rates on these before making your request.
Other fees due:
$__________________
Total fees due: $_______________________
Total fees enclosed:
$__________________
PLEASE READ PAGE 2.
There are two pages to complete and sign before your reservation request can be submitted. If you are
missing Page 2 or have questions regarding either Page 1 or 2, please notify the Council Service Center in Jefferson at the number above. Requests
cannot be filled without both pages.
Approved by: _______________
Council Properties Reservation Form
Date: _____________________
Page
1 of 2
Check#/CC _________________
Updated: 2/10/10
Received: __________________

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