Camp Sequiyah - Campership Application - Boy Scouts Of America

2016 Campership Application

Camperships are for Scouts registered in the Greater Alabama Council

Attending Camp Comer or Camp Sequoyah

(Due March 31, 2016)

Camp:

Sequoyah_____________________

Comer:______________________

Date: ______________ (for Council use. Date application received)

Camper’s Name: ____________________________________ Unit Number__________ District: ____________________

Address: __________________________________________ City: _______________________ Zip: _________________

Phone: ___________________________________________ Institution: _______________________________________

This is to certify that I have personally talked with the above named Scout regarding his attendance and have interviewed

his parent(s) or guardian and present the following plan for his attendance fee:

Reservation Fee: 75.00 (attached or paid previously; due February 14, 2016 for all Scouts attending camp)

Amount Scout and Family Will pay:

$ _____________________________

Amount Unit or Chartered Organization will pay: $ _____________________________

Amount of Campership requested:

$ ______________________________ (142.50 Maximum)

Total Fee:

$285 Camp Sequoyah or Camp Comer

Note: Full payment (less campership amount) is due 30 days prior to camp to retain campership.

This Scout needs financial aid because ___________________________________________________________________

__________________________________________________________________________________________________

Unit Leader Approval

Name: _____________________________________________ Position in Scouting: ______________________________

Address: __________________________________________ City: _______________________ Zip: _________________

Phone: (H) ________________________________________ (W) _____________________________________________

Week Scout will attend camp: ______________________________________________________________________

I hereby certify that my son may participate in the activity/Camp. I also give consent for medical treatment for him if, in

the opinion of the Camp Director or the Medical Officer it is necessary.

Parent’s or Guardian’s Signature: _______________________________________________________________________

Address: ____________________________________ City: _______________________ Zip: _______________________

Phone: (H) ___________________________________ (W) __________________________________________________

District Executive concurrence signature: _____________________________________________________

Action of Camping Committee:

Forms should be submitted by either:

Amount of Campership awarded: $ _________________

Mailing: Greater Alabama Council

Date Unit Leader notified: _________________________

516 Liberty Parkway, Birmingham, Alabama 35242

Faxing: 205-970-0349

Emailing:

Camp Sequiyah - Campership Application - Boy Scouts Of America - 2016