8/12/2019 Registration Form for Cub Scout Summer Camps Fillable PDF v4

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2014 Cub Summer Camp Registration

Cub Scouts name:____________________________________________________________

Adult name attending camp: ____________________________________________________

Camp adult participation: Monday Tuesday Wednesday Thursday Friday All week Resident Camp

Address: __________________________________________________________________________

City: ____________________________ Zip: __________ Phone: (______) ________ - _________

Email: __________________________________________________________________ Pack #__________

Grade in fall 2014: 1st 2nd 3rd 4th 5th

Program level in fall 2014: Tiger Wolf Bear Webelos 1 Webelos 2

Cubs T-Shirt size : Youth small Youth medium Youth large Adult small Adult medium Adult large Adult XL

Required: Health form Shooting sports authorization Optional: Special needs (website) Campership (website)

Fee Summary

Youth Camp Fees: $_____ Adult Fees: $______ Extra T-Shirt: $________ Total: $__________

Payment: Cash Check (payable to SVMBC) Credit Card

If paying by credit card: Name on card: _____________________________________________________

Credit card number: ________ ________ ________ ________ Exp:___ / ____ Security code: ______

Signature: _____________________________________

Camp Cost Total

Lake Cunningham day camps (Fishing and a Friday fun day at Raging Waters) $195 $_____Stevens Creek day camps (BBs & Archery at the Sunnyvale Rod & Gun Club & Fishing)$150 $_____

Morgan Hill Day Camp (Achievement Oriented Camp, Tigers!) $150 $_____

Vasona Day Camp (Cub Scout School of Magic!) $150 $_____

Loma Prieta Towaba (Swimming, Obstacle Course, & more) $125 $_____Vasona Twilight Camp (Twilight Cub Scout School of Magic & Tigers!) $95 $_____

Santa Lucia day camps (*SL North Laguna Seca Friday fun day & Tigers!) $80 $_____Fort Benito (Achievement Camp & Webelos Overnight on Wednesday) $65 $_____

Loma Prieta Chenoa (Achievement Oriented Camp and Tigers!) $60 $_____

*Registration Day (3/22) or Group (4 or more) Discount of $10 per youth (-$_____)

Resident Camp__________________________________Early Bird (Before 4/15)____Regular__________

Cub Adventure resident camp $150 $180 $_____

Webelos resident camps $210 $240 $_____

Resident camp @ Pico Blanco $210 $240 $_____Adult Fees_______________________________________________________________________________

Cub Adventure resident camp $50 $80 $_____

Webelos resident camps $115 $145 $_____

Pico Blanco resident camp $115 $145 $_____

Additional T-Shirts _____ @ $10 each $_____

Grand Total: $_____

Phone: 408-638-8300 970 West Julian Street E-mail: CubCamp@svmbc.orgFax: 408-280-5162 San Jose, CA 95126 Website: www.svmbc.org/cubcamp

mailto:CubCamp@svmbc.orghttp://www.svmbc.org/cubcamphttp://www.svmbc.org/cubcampmailto:CubCamp@svmbc.org

8/12/2019 Registration Form for Cub Scout Summer Camps Fillable PDF v4

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Dont Play the Game, Live the Game!

2014 Cub Summer Camp Information

Youth Camp Fees

Registrations are accepted for on March 22 at the Scout service center. One T-Shirt for each youth is provided for Camp. Additional T-Shirts are available for $10 for adults or youth. Registration Day (3/22) or Group (4 or more) Discount of $10 per youth.

Day Camps

Lake Cunningham: June 23-27 July 21-25

Stevens Creek : July 14-18 July 28 August 1

Fort Benito : June 16-20

Loma Prieta Chenoa: June 16-19

Loma Prieta Towaba: July 14-18

Santa Lucia N. County June 23-27

Santa Lucia South County June 16-20

Morgan Hill: June 16-20

Vasona Day Camp: June 23-27

Vasona Camp (Twilight Camp) June 23-27

Resident Overnight Camps

Chesebrough Webelos Camp: June 12-15 June 19-22

Chesebrough Cub Adventure: June 16-18

Pico Blanco Resident Camp: July 3-6

Adult Participation

All Day camps and Twilight camps: An adult must attend at least two days of camp OR a pack must provide a ratio of 1:4,adult to youth, each day.

Cub Adventure resident camp: A minimum ratio of 1:2, adult to youth, is required.

Webelos resident camp: A minimum ratio of 1:4, adult to youth, is required.

Be sure to attend the pre-camp orientation. See frequently asked questions (FAQ) on the website for more information.

Health Form and Permission Form for Cubs and Adults

All Day camps and Twilight camps: The BSA health form (parts A and B) and the permission to use a firearm (for the BBguns) are to be completed and turned in for the registration to be considered complete. These forms are requested at thetime of registration.

Cub Adventure resident camp: The BSA health form (parts A and B) and the permission to use a firearm (for the BBguns) are to be completed and turned in for the registration to be considered complete.

Webelos resident camp: The BSA health form (parts A and B and C with a current medical examination) and the per-mission to use a firearm (for the BB guns) are to be completed and turned in for the registration to be considered complete.These forms may be brought to camp with the youth and adult campers.

See website for more information and to download the forms. For all camps except Webelos resident camp, theseforms should be submitted with the camp registration form at the time of registration. The forms should be brought tocamp for the Webelos camps. The health form is required for both youth AND adults. To comply with confidential informationstandards, the health form should not be emailed to the service center.