2016 STEM Camp Indiv. Info Form
User Manual: 2016-STEM-Camp-Indiv.-Info-Form
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Pennsylvania Dutch Council Camp Mack Boy Scouts of America 2016 STEM CAMP Individual Information Form July 23-25, 2016 Complete this form and return it with a copy of your completed health form WITH PAYMENT FOR ALL FEES LISTED to YOUR PACK before or by April 22nd, 2016 so your Pack can turn it in on time and avoid a LATE FEE! Read this form completely (front and back) before beginning! √ Step 1: Fill in Scout / Pack Information: Scout √ Step 3: Figure Out Camp Fees Pack # Use this box to figure out your camp fees. Street City , State _______ Zip _______ E-mail (6STMC) Late Fees: _____ x $25.00 = __________________________ Phone SCOUT T-SHIRT: Youth Camper: _____ x $175.00 = _______________ (Applies after May 6, 2016) Grade in September: Youth L Adult S Adult M (6STMC) Adult Camper: _____ x $105.00= ___________________ Adult L (6STMC) (Please circle size. Price included in camp fee if paid by May 6. See Back for more information.) Adult Shirt (opt.): _____ x $12.00= ________________ √ Step 2: YES, I’ll come to camp with my Scout! Adult / Leader (6STMS) Family Night Dinner Guests: x $8.00 = ______________ (all campers & all guests age 5 & under eat free) (6STMM) Street City Camp Photo: , State ______ Zip E-mail (6STMP) Subtract Deposit Paid: _____ X -$25.00 = ____________ Main Phone ADULT T-SHIRT: x $8.00 = _______________ (If you previously paid a deposit subtract it here. Deposits are Non-Refundable) Alt. Phone Sm Med Lg XL 2X 3X (Optional: purchase price $12.00 is not included in adult camper fee) Subtract Campership/Popcorn Prize: -______________ (Must attach copy of Campership or Popcorn Prize letter from PA Dutch Council to receive credit) TOTAL PAID TO PACK: _______________________ PA Dutch Council does not maintain information on individual “Scout Accounts” nor can it give credit for funds in these accounts. If your pack uses “Scout Accounts” use of those funds for summer camp is between you and your Pack. √ FINAL STEP: Complete the following additional required forms: Annual BSA Health and Medical Record (Parts A & B only) for every camper (Scout & adult) listed above, BMX Pump Track Hold Harmless Form, Camp Mack Special Dietary Needs Form, PA Background Clearances, and Youth Protection Training for each adult. Once complete, attach a COPY of these forms to this registration form. Turn your packet and a check made out to your Pack into your pack by April 22, 2016. *SEE OTHER SIDE FOR IMPORTANT INFORMATION* Pennsylvania Dutch Council 630 Janet Ave. Suite B-114 Lancaster, PA 17601 717-394-4063 www.padutchbsa.org Pennsylvania Dutch Council Camp Mack Boy Scouts of America STEM Camp Important Information – Please Read STEM Camp is intended to be a summertime camping experience for all Cub Scouts. Scouts are encouraged to make plans to attend camp, with adults attending with their sons. It is the responsibility of the Pack to secure sufficient adults following the guidelines in the Camp Adult Guide and on the Camp website www.padutchbsa.org/camping/mack. INDIVIDUAL REGISTRATION: If you plan on attending STEM Camp and no one else from your Pack is planning on attending the same session, you can still come! In this case, an adult family member (21 years of age or older) must accompany your Cub Scout. To register as an individual, fill out this form and send it directly to the PA Dutch Council Service Center with payment and all required attachments. FEES: Discount STEM Camp Fee (Received at Council Service Center by May 6) Regular STEM Camp Fee (Received at Council Service Center after May 6) Adult Fee Family Night Dinners (campers and children under 5 free) Scout Den Photo Adult T-Shirt (Optional) $175.00 $200.00 $105.00 $ 8.00 $ 8.00 $ 12.00 Camper and adult fees include all meals, program materials, and a camp patch. Youth camper fees also include a water bottle. Youth t-shirts are included in the camper fee if paid by May 6. After May 6 youth t-shirts will be available at the camp trading post while supplies last. Adults may want to purchase a T-shirt. The Trading Post will be open daily with cold drinks, snacks, Camp Mack mementos, etc. for purchase. > Make your check payable to your Pack to cover all fees shown above. > Summer camp fees are due in the Council Service Center NO LATER than May 6th in order to receive the discounted fee. NO EXCEPTIONS will be made to this policy. Payment received after May 6th must be for the Regular Fee listed above and will not include a youth t-shirt. Be sure you submit your paperwork and check to your Pack by April 22, 2016 so they have time to meet the May 6th discount deadline. > All adults attending camp must complete the PA Background Clearances and Youth Protection Training prior to attending camp whether they are registered members of the BSA or not. > REFUNDS: The PA Dutch Council Camp Refund Policy will be strictly followed. A copy of this policy can be found in the Camp Adult Guide and on the camp website www.padutchbsa.org/camping/mack. > MEDICAL FORMS are required for every youth and adult camper. At the end of your camp session the medical forms will be returned. Be sure to make copies before you come to camp. Keep the original at home in a safe place to use again. Copies cannot be made at camp. MEDICAL FORMS ARE REQUIRED FOR EVERYONE AS FOLLOWS: STEM Camp Medical Form: Annual BSA Health and Medical Record Parts A & B plus the Camp Mack Special Dietary Needs Form CHECK OUT THE COUNCIL WEBSITE: www.padutchbsa.org for more information on other camping opportunities. Pennsylvania Dutch Council 630 Janet Ave. Suite B-114 Lancaster, PA 17601 717-394-4063 www.padutchbsa.org
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