Unit & Personal
Registration Information:
Unit #
Council Name:
Council HQ City:
Scoutmaster's Name:
Boy Scout's Name:
Your Name:
Address 1:
Address 2:
City:
State:
Zip:
Contact Phone #:
Emergency Phone #:
Email Address:
Please register my son as a
Provisional Camper at Camp Blue Heron during the summer of 2008. I
understand that my son will be placed in a campsite with an attending troop
that welcomes Provisional Campers and will be assigned to the representing
Scoutmaster or adult Campsite Leader for the week.
Choose Summer Camp Week:
Choose Classes Your Scout will
be taking:
VIEW
MERIT BADGE
AND AWARDS OFFERED LIST
Class Session #1:
Class Session #2:
Class Session #3:
Class Session #4:
Class Session #5:
Class Session #6:
Evening Classes:
Evening Activities:
T-Shirt Size Only for COPE:
Summer Camp Form
Printing Area
PRINT HOLD HARMLESS AGREEMENT, FIELD TRIP PERMISSION,
& PHOTO RELEASE FORMS
Medical Form Class 1
and 2
Medical Form Class 3
(Required for any High Adventure Programs)
Payment Method: Credit Cards Only
Payment for Provisional
Scout:
Plus any
additional Fees from Above selections
Credit Card Type:
Card Numbers:
American Express Card
Numbers Here:
Expiration Month:
Expiration Year:
Name as it Appears on Card:
2008 PROVISIONAL SCOUT
CAMP BLUE HERON