Etowah District Day Camp by HC12072710457


									Mecklenburg County Council Day Camp 2009
Medieval Cub Camp
June 29th – July 2nd
Camper Application Form
Mecklenburg County Council – Boy Scouts of America

Please make $80 check payable to your Pack. Complete Application and Payment is due to the designated
Day Camp Coordinator for your Pack or to your Cubmaster. No registrations will be accepted at the
Council Scout office. Registration fills up quickly and there are no guarantees for space availability.

 If a parent or guardian volunteers for a FULL WEEK, a $20 discount will apply toward one scout
application fee.

Camperships (financial aid) are available; please see your Cubmaster.

Camper’s Name: ________________________________________________                 Nickname: ___________________________

Age: _________ Date of Birth: ____________      Current Grade in School (As of April 1st): 1st          2nd 3rd 4th

Current Rank in Scouting (As of April 1st):       Tiger      Wolf  Bear  Webelos                     Pack # _______

Address: ______________________________________________City: ____________________ State: _____ Zip: ________

Parent’s Name: _______________________________________Phone # (E) _________________ (M) __________________

Email Address for confirmation of Camp Registration: ________________________________________________________

T-shirt size?     Youth Large Adult Small           Adult Medium Adult Large (1 T-shirt will be provided.)
Additional t-shirts may be purchased for $5 each. Please circle number of additional t-shirts desired.    0   1   2   3

     Parts A and C of the BSA Annual Health and Medical Record form
                     Must be completed and attached.

                                         Any questions Email

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