Cub Scout Summer Camp Registration Form

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2016 Cub Scout Summer Camp Registration
Cub Scout’s name:____________________________________________________________
Adult name attending camp
___________________________________
(see Adult participation on page 2):
Adult participation:
 Monday  Tuesday  Wednesday  Thursday  Friday  Resident Camp
Address: __________________________________________________________________________
City: ____________________________ Zip: __________ Phone: (______) ________ - _________
Email: __________________________________________________ Pack #__________District:__________
Grade in fall 2016:  1st  2nd  3rd  4th  5th
Program level in fall 2016:  Tiger  Wolf  Bear  Webelos 1  Webelos 2 (Arrow of Light)
Cub’s T-Shirt size :  Youth small  Youth medium  Youth large  Adult small  Adult medium  Adult large  Adult XL
One T-Shirt for each youth is provided for Camp. Additional T-Shirts are available for $10 for adults and youth.
Required:  Health form  Copy of Medical Card  Shooting sports authorization
(see page 2)
Optional:  Special needs (website)  Campership (website)
Camp
Cost
Total
Quicksilver Cub Camp (one day) : 6/11 (Achievement Oriented Camp & Tigers!)
$40
$_____
Fort Benito: 6/13-17 (Achievement Camp & Webelos Overnight on Wednesday)
$65
$_____
Vasona Day Camp: 6/13-17 (S.T.E.M. focused and strategy games)
$165
$_____
Vasona Twilight Camp: 6/13-17 (S.T.E.M. focused, strategy games & Tigers!)
$100
$_____
Morgan Hill Day Camp: 6/13-17 (Achievement Oriented Camp & Tigers!)
$150
$_____
Santa Lucia South: 6/13-17 (Shooting Camp & Tigers!)
$100
$_____
Lake Cunningham Camp #1: 6/20-24 (Fishing and Friday fun day at Raging Waters)
$200
$_____
Loma Prieta Chenoa: 6/20-23 (Achievement Oriented Camp and Tigers!)
$70
$_____
Santa Lucia North: 6/20-24 (Thursday Laguna Seca & Tigers!)
$100
$_____
Loma Prieta Towaba: 7/11-15 (Achievement Oriented, Shooting Sports & Tigers!)
$150
$_____
Loma Prieta Towaba Webelos Overnight: 7/15-16 (Campfire, games & more)
$25
$_____
Steven’s Creek Camp #1: 7/11-15 (Shooting Camp Sunnyvale Rod & Gun Club)
$160
$_____
Lake Cunningham Camp #2: 7/18-22 (Fishing and Friday fun day at Raging Waters)
$200
$_____
Steven’s Creek Camp #2: 7/25-29 (Shooting Camp Sunnyvale Rod & Gun Club)
$160
$_____
Extra T-Shirt (all camps)
$10
$_____
 Youth small  Youth medium  Youth large  AS  AM  AL  AXL
Resident Camp___________________________________________________________Costs__________
Webelos Resident Camp #1 6/09-12
$245
$_____
Webelos Resident Camp #2 6/16-19
$245
$_____
Webelos Resident Camps Adult Fees
$150
$_____
Extra T-Shirt (all camps)
$10
$_____
 Youth small  Youth medium  Youth large  AS  AM  AL  AXL
Grand Total:
$_____
Fee Summary
Payment:
 Cash
 Check (payable to SVMBC)  Credit Card
If paying by credit card: Name on card: _____________________________________________________
Credit Card Number: ________ ________ ________ ________ Exp:___ / ____ Security code: ______
Signature: _____________________________________
Phone: 408-638-8300
970 West Julian Street
E-mail:
Fax: 408-280-5162
San Jose, CA 95126
Website:

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