| STAFF USE ONLY: T_____ C_____ A_____ J_____ D_____ Hopkins District Day Camp: 2009 Cubs in Space CUB SCOUT APPLICATION 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): | | Name:__________________________________ | Name:__________________________________ | | Daytime Phone: (_____) _______________ | Daytime Phone: (_____) _______________ | | Relationship:_________________________ Email Address: __________________________ | Relationship:_________________________ | 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 NO REFUNDS WILL BE MADET-Shirts: Each Cub Scout receives 1-Day Camp Shirt on the first day. Additional shirts may be ordered @ $10.00/shirt. Payment Information Registration: | $ | 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: ____________________________________________ | 
