Special Use Application Form

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Monmouth Council
Boy Scouts of America
Quail Hill Special Use Application
(Picnic Area, BB Guns, Archery, Swimming Pool, Canoes, John Boats)
(Circle One)
(Please print all information)
Pack/Troop
Team/Post/Crew #________
Council/Group:________________________________________
Persons In Charge:
Name (Age 21+)_______________________________________ Position _______________________________________________
Address _________________________________________ City ___________________________ State _______ Zip ___________
Phone: (H) _____________________________ (C) ______________________________ Email ____________________________
Name (Age 18+)_______________________________________ Position _______________________________________________
Address _________________________________________ City ___________________________ State _______ Zip ___________
Phone: (H) _____________________________ (C) ______________________________ Email ____________________________
Picnic Areas and Campfire Bowl:
Three picnic areas are available for unit and family picnics year round.
( ) Maricopa - $35.00 ( ) Pima - $35.00 ( ) Gas Grill - $25.00 ( ) Campfire Bowl - $10.00 ( ) Shooting Sports Pavilion - $50.00
Date_______________
Arrival Time________________
Departure Time________________
Participants Expected:
Youth____________
Adult___________
Total____________
BB/Archery Range: Fees for either the BB or Archery Ranges are $15.00 per hour per range. This includes weapons, and materials. The unit must
provide an adult with a current Monmouth Council BB/Archery certification for each range to supervise the program. (current NRA certified
Instructors and police officers are considered certified to supervise the BB range) NO PERSONAL WEAPONS
( ) BB Gun Range
( ) Archery Range
Date_______________
Arrival Time________________
Departure Time________________
Participants Expected:
Youth____________
Adult___________
Total____________
Adult Rangemaster__________________________________
Certification_______________________________
Swimming Pool: The pool is available on weekends June thru August when not scheduled for day camp or resident camp. Groups using the pool
must have one certified lifeguard (BSA or Red Cross) for every group of up to 30 swimmers. One lifeguard MUST be supplied by Monmouth
Council at $10/hour. Additional lifeguards are available at $10/hour. In addition the group must supply adults as lookouts equal to a ratio of 1 lookout
for every 10 swimmers. Non-Scouting groups must demonstrate proof of insurance and provide a hold harmless agreement to the Monmouth
Council. The rental charge for the pool will be $50.00 per hour. (minimum 2 hours)
Date_______________
Arrival Time________________
Departure Time________________
Participants Expected:
Youth____________
Adult___________
Total____________
Lifeguard__________________________________________
Qualifications________________________________
Canoes and Jon Boats (Boy Scouts only) Rentals include canoes or Jon boats, life jackets and paddles or oars. Canoes may be removed from the
camp premises, but units are responsible for transportation and the safe use of the canoes. A trailer is available at no extra charge when six canoes are
rented. Jon boats are only for use on Kiely Pond at Quail Hill. The Boy Scouts of America Safety Afloat Guidelines will be enforced. All adult
supervision must complete Safety Afloat training. A security deposit per canoe or Jon boat is due at check-in and will be returned when the unit
returns the canoes/boats. Damages will be deducted from the deposit at the discretion of the Ranger. Overnight rentals will be charged for two days.
Rental Fees:
Off site canoe - $15.00 per day (plus security deposit)
Number needed ___________
On site canoe - $5.00 per half day
Number needed ___________
On site Jon Boat - $5.00 per half day
Number needed ___________
Date_______________
Arrival Time________________
Departure Time________________
Participants Expected:
Youth____________
Adult___________
Total____________
Submit this application to Monmouth Council, BS.A, 705 Ginesi Dr., Morganville, NJ 07751 Phone 732-536-2347. Please submit at least 30 days
in advance of arrival date. All fees are non-refundable and must accompany this application. Make checks payable to Monmouth Council, BSA
_______________________________
______________________________
Signature of Committee Member
Signature of Leader
Office Use Only:
Date______________ Receipt #______________ Amount Paid______________ Deposit________________
R
evised 07/2013
Page 18

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