Bsa Unit Application For Summer Camp Form

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BOY SCOUTS OF AMERICA
(740) 453-0571
(800) 934-2128
MUSKINGUM VALLEY COUNCIL
2016
734 MOOREHEAD AVE
ZANESVILLE, OH 43701
Unit Application for Summer Camp
Muskingum Valley Scout Reservation
This form is necessary to complete our records. Please fill out and return to the council office.
Each unit camping must pay the Unit Reservation Fee.
NOTE: A $75.00 UNIT RESERVATION FEE MUST BE RETURNED WITH THIS APPLICATION.
THIS IS NOT TRANSFERABLE OR REFUNDABLE
1. Camp leader and Scoutmaster information is necessary for our mailing
If out of council: Please list carrier and policy number
for your Unit/Council Accident Insurance.
records. Please indicate complete addresses.
_____________________________Carrier
Unit Type/Unit #_________________
_____________________________Policy Number
Council Name/# __________________________________
2. Unit Leader ________________________________________ Daytime Phone # (______) _______-_________
E-mail: ___________________________________________ Cell Phone # (_______) ________-_________
Address _____________________________________________________________________________________
Street
City
State
Zip
3. Camp Leader _______________________________ Age _______ Daytime Phone # (_______) ______-________
E-mail: ___________________________________________ Cell Phone # (_______) ________-_________
Address _____________________________________________________________________________________
Street
City
State
Z
4. Campsite (please mark first, second, third choice).
____Hopewell—Adirondack
____Friendship
____Frederickson
____Hopewell
____Zane
____Delaware
____Walnut—Lower
____Eagle
____Whiteyes
____Walnut—Adirondack
____Buckeye
____Appleseed—Adirondack
5. Estimate on camp attendance: We plan to have ______scouts and ______leaders at MVSR this year.
(Please estimate carefully. These numbers are critical to our planning. In some cases, two small troops may
be asked to share a site.
6. Camp period: Please mark first and second choice, if possible.
____First Week
____Second Week
____Third Week
____Fourth Week
____Fifth Week
Note: This form may be turned in at camp when paying the next camping season unit reservation.
Unit Reservation Paid: ___________(date)
Receipt # ______________ Amount _____________
NOT TRANSFERABLE OR REFUNDABLE
Unit Reservation Form: Revised 11/03/2015

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