Jackson - Camp Use Permit - Boy Scouts Of America

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GREATER ALABAMA COUNCIL
BOY SCOUTS OF AMERICA
Jackson - Camp Use Permit
Application Date: __________________
Unit Type & Number: _____________________ District: ________________
Number of Youth: _______ Adults: ________
Arrival Date: ________ Arrival Time:________ Departure Date: _______ Departure Time: _________
What is your program plan while you are in Camp? _________________________________________________________
Will you use:
_____ Administration Building
_____Dining Hall
_____ Kitchen
_____Canoes
_____Swimming
_____ Pump Track Bikes/Pump Track
st
th
(Seasonal, April 1
-Sept 30
)
LEADER IN CHARGE MUST BE PRESENT AT CAMP AT ALL TIMES OF USE.
Leader in charge: ___________________________________________________________________________
Address: ______________________________ City: __________________ State: _________ Zip: _________
Phone: (H)_______________________ (W) ______________________ (C)_____________________________
Email: _____________________________________________________________________________________
Fees for equipment are to be collected by the Ranger prior to use.
GAC Units &
Out of Council /
Charter Partners
Other Groups
Day events & Camping
$0
$2.00
Per Person
Administration Building
$25
$50
Per Day
Dining Hall ONLY
$50.00
$150.00
Per Day
Pump Track Bikes / Pump Track
$0
$5.00
Per Bike, Per Day
Kitchen
$100.00
$150.00
Per Day
Per Canoe – Per Day
Canoes (onsite)
$0
$10.00
Paddles and PFD’s included. Must meet all BSA safety requirements
Anyone climbing or rappelling on the Pinnacle must have a BSA certified Climbing/rappelling
instructor and must have adult certified Climb on Safely, CPR and Wilderness First Aid. Units must
supply their own climbing and rappelling equipment.
BSA Climbing Trip Leader Certification – Forms must be sent in at same time as camp use permit
Office Use ONLY:
Date Received: ____________
Date Confirmed with Unit Leader: _________________
Date Processed: ___________
Date Confirmed with Ranger: _____________________
Approved By: _____________

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