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BUCKS COUNTY COUNCIL |
BOY SCOUTS OF
AMERICA |
(Please Print)
NAME:____________________________________________ TROOP #:___________
STREET ADDRESS:_______________________________________________________
TOWN:_____________________________ STATE:______ ZIP CODE:____________
TROOP INSURANCE COMPANY:________________________ POLICY #:________
DATE OF BIRTH:______/______/______ AGE ON
JUNE 15th, 2006:__________
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SCOUTMASTER INFORMATION: All provisional campers are placed with a host
troop for the week. Occassionally, the leaders of host troops request to
contact the provisional camper's scoutmaster for information about the scout's
advancement, scout skills and leadership ability. Please have your
Scoutmaster complete the following: Should the troop hosting this scout have
any questions they can contact me: Scoutmaster's
Name:________________________________________________ Phone:___________________________ |
Select camping session:
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_____ Scout Week #1: June 18-24, 2006 |
_____ Scout Week #5: July 16-22, 2006 |
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_____ Scout Week #2: June 25-July 2, 2006 |
_____ Scout Week #6: July 23-July 29, 2006 |
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_____ Scout Week #3: July 2-8, 2006 |
_____ Scout Week #7: July 30 - Aug 5, 2006 |
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_____ Scout Week #4: July 9-15, 2006 |
_____ Scout Week #8: Aug. 6-12, 2006 |
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Select fee that applies:
_____ PLAN A: $340.00 per Boy Scout attending a week of Boy Scout Summer Camp for the first time this summer.
_____ PLAN B: $260.00 per Boy Scout returning to Ockanickon for a second week of Boy Scout Summer Camp this season.
AMOUNT OF CHECK ENCLOSED: $__________.
(Make checks payable to: Bucks County Council, B.S.A.)
THE FULL FEE IS DUE WITH THIS APPLICATION - ALL FEES ARE NON-REFUNDABLE
MAIL APPLICATION TO:
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(before June 1, 2006) |
(after June 1, 2006) |
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Provisional Camping Coordinator |
Provisional Camping Coordinator |
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Bucks County Council, B.S.A. |
Ockanickon Scout Reservation |
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1 Scout Way |
5787 State Park Road |
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Doylestown, PA 18901 |
Pipersville, PA 18947 |
NOTE: A completed and
current Class 2 Medical Form is required upon arrival at camp. Copies of this
form may be obtained at the Council Service Center or directly from camp.
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