Buckskin Scout Reservation

PROVISIONAL SCOUT APPLICATION

The Provisional Scout Program is designed for the Scout who wants to attend camp for more weeks than his troop is in camp, or who is unable to attend when his troop is in camp, or whose troop cannot come to camp. Qualified adult leadership is provided by the camp staff for all Provisional Campers.

The fee for attending as a Provisional Camper is $150.00 per week if paid by May 15 and $175 if paid thereafter. Fees are due to the Scout Service Center two weeks prior to attendance at camp. This application is due with the $50 deposit. The deposit is transferable, but it is not refundable.

SCOUT'S NAME ______________________________________________________________

ADDRESS __________________________________________________________________

__________________________________________________________________

TELEPHONE _________________________ AGE ________ TROOP # ______________

CURRENT RANK _______________________

WEEK PREFERRED:

We hereby make application for our son to attend Buckskin Scout Reservation as a Provisional Camper. We will make certain that he is prepared by being properly equipped, has a completed medical form and that his fees are paid by May 15, prior to his arrival at camp. We understand that we are responsible for his transportation to and from camp and that the enclosed fee deposit is transferable, but not refundable.

PARENT'S SIGNATURE_________________________________________________________

In case of Emergency please contact:

Name:_________________________________ Home phone: (____) ____________

Address:__________________________________ Business phone: (____) ___________

Fax: (____) ___________

City:_____________________________ State:_____

Relationship to Scout:_________________________________