STAFF USE ONLY: T_____    C_____    A_____    J_____    D_____



Hopkins District Day Camp: 2009 Cubs in Space



Note: All questions must be answered or forms will not be processed. PLEASE PRINT!


Pack Number: _______________ 


Participant's Name: __________________________ Nickname: ___________

Street Address: ____________________________________________________

City/State: ________________________________ Zip Code: _______________

Home Phone (_____) _____________ Birth date: __________ Age:__________

Please note: Since we assign dens according to rank, be careful when answering the following 2 questions. Remember, all Cub Scouts in the Baltimore Area Council advance in rank as of June 1st, 2009(If you have questions, ask your Cubmaster, Den Leader or Committee Chair)

If scout was a Tiger between 6/2008-5/2009 register him as a Wolf for camp this summer. If scout was a Wolf between 6/2008-5/2009, register him as a Bear for camp this summer. If scout was a Bear between 6/2008-5/2009, register him as a Webelos I for camp this summer. If scout was a Webelos I between 6/2008-5/2009 register him as a Webelos II for camp this summer. If the scout was a Webelos II between 6/2008-5/2009, he will be in Boy Scouts next year and is welcome to apply to camp as a Youth Crew- use youth crew form.

Cub Scout Rank at Day Camp 2009                    Wolf  _ Bear _   Webelos I _ Webelos II _

Elem. School Grade Entering 09/2009                 2nd  _    3rd   _                4th  _               5th  _

Parent/Guardian Information:

Emergency Contact (other than parent/guardian):



Daytime Phone: (_____) _______________

Daytime Phone: (_____) _______________


Email Address: __________________________


Registration Fees: 3, 4, or 5-day ADULT volunteers must complete the adult application and health form.

_ $25.00 w/5 day volunteer               __$30.00 w/4 day volunteer    

__$40.00 w/3 day volunteer                 _ $50.00 w/o volunteer


T-Shirts: Each Cub Scout receives 1-Day Camp Shirt on the first day. Additional shirts may be ordered @ $10.00/shirt. 

Payment Information



Add`l Shirts:




Total for this form:



Shirt sizes are ADULT Sizes!! Remember � a larger shirt is better than one too small!

Check  correct size below:            __ Adult Small   __ Adult Medium   __ Adult Large

Number of shirts: 1 FREE shirt plus ____ additional shirts @ $10.00/shirt = $ ________ 

Medical Information: (No one will be allowed in camp without this form!)

I have attached the required medical form to this registration. Initial Here:  ______   

Make one check for the entire family payable to BSA/BAC and attach the check to the Hopkins Day Camp Family Tally Sheet. Attach all Individual Application Forms, Medical Forms, and copies of Certification Cards together

Parent/Guardian Signature & Date: ____________________________________________



 Hopkins District BAC-BSA - 701 Wyman Park Drive, Baltimore MD 21211 - Phone (443)-573-2527 -
Fax (443)-573-2627