Girl Scouts Of Gulfcoast Florida Service Unit Camp Site Reservation Form
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1Service Unit Camp Site
Reservation Form
Received in council
Please complete this form to request day or overnight service unit camping. Refer to the council website for Camp Rules, Safety-
Activity Checkpoints and specific camp information. A $100 deposit must accompany this form in order to process the requested date.
Today’s date _______________________ Camp times: Day use - 12 p.m. - 5 p.m. Overnight use - 6 p.m. - 11 a.m.
Event coordinator name _________________________
Event title________________________________ Service unit ________
Address _________________________________________________________________
City _____________________________
State ___________ Zip ___________ Email address ____________________________________________________________
Phone number _________________________________________
Cell number ________________________________________
Please provide a 1
, 2
, and 3
choice of date, camp, and unit(s). Listing three choices increases the likelihood of being placed.
st
nd
rd
GIRL SCOUT CAMPS - Camp Caloosa (capacity 131) | Camp Honi Hanta (capacity 178)
FIRST CHOICE
SECOND CHOICE
THIRD CHOICE
Camp ____________________________
Camp ____________________________
Camp ____________________________
Unit(s) ___________________________
Unit(s) ___________________________
Unit(s) ___________________________
Day use - 12 p.m. - 5 p.m.
Day use - 12 p.m. - 5 p.m.
Day use - 12 p.m. - 5 p.m.
Overnight use - 6 p.m. - 11 a.m.
Overnight use - 6 p.m. - 11 a.m.
Overnight use - 6 p.m. - 11 a.m.
Check-in date
_____/_____/_________
Check-in date
_____/_____/_________
Check-in date
_____/_____/_________
Check-out date _____/_____/_________
Check-out date _____/_____/_________
Check-out date _____/_____/_________
Number of girls ________ Number of adult females ________ Number of adult males ________
Grade level(s):
K-1
2-3
4-5
6-8
9-10
11-12
Multi level
(Daisy)
(Brownie)
(Junior)
(Cadette)
(Senior)
(Ambassador)
Requesting use of:
Golf cart
Commercial kitchen - Name of trained Event Cooking facilitator___________________________
I know, understand, have read, and agree to meet the requirements set forth for this activity in Safety Activity Checkpoints, Volunteer
Essentials, and GSGCF policies and rules.
Signature ______________________________________________________
Date _______________________
PAYMENT INFORMATION:
REFUND POLICY:
A deposit of $100 MUST be submitted with each
1. 60 days prior to the reserved date, full refund of amount paid.
service unit camping request.
2. 59 – 45 days prior to reserved date, half of the amount paid will be
refunded.
Balance due 30 days prior to the reservation date.
3. 44 days prior to reserved date, NO REFUND.
Registrations completed less than 4 weeks prior to the
4. Less than two weeks prior to the reserved date, service unit will be
reservation date must be paid in full at time of request.
charged a cancellation fee of $150 (
as this does not allow others to reserve).
OFFICE USE ONLY:
PAYMENT TYPE:
Cash
Check #: ________
Credit Card
Date approved ____/____/____ Initials ______
Account Number ____________________________________________
Please charge my:
Master Card
Discover
Visa
American Express
Amount to charge for deposit $ _________________
Credit Card # _____________-____________-____________-____________
Balance due: $ ______________
Balance due date ____/____/____
Refund amount: $:____________
Refund date: ____/____/____
Expiration date ____/____
Amount $ _____________
Cardholder’s Name (print) ___________________________________________
Girl Scouts of Gulfcoast Florida, Inc.
4780 Cattlemen Rd., Sarasota, FL 34233
Cardholder’s Signature _____________________________________________
800-232-4475 or 800-232-4475
Email: • Website:
C:SHELFFORMS/2015Forms/ SU Campsite Reservation Form Rev. 12-15
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