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Camp Mack
Pennsylvania Dutch Council
Boy Scouts of America
J.E.MACK SCOUT RESERVATION- 2015
Cub Scout Resident Camp -Payment Transmittal Form
for Packs
If your Pack is signing up for multiple sessions, please use separate form for each
session
_____Session 1, June 19-21 _____Session 2, June 26-28
Unit:
Unit Contact:
Address:
Contact Email:
Step 1
District:
Council:
Daytime Phone:
City:
State:
Zip:
Gather Information:
Collect Cub Scout Resident Camp Individual Information Forms, required attachments, and checks
made out to your Pack for all Cubs and adults planning on participating in Cub Scout Resident Camp.
Figure Out Total Session Fees:
Use this chart to figure out the total amount due for this session. When finished, attach one Pack
check made out to Pennsylvania Dutch Council, BSA. This form and payment is due to the
Pennsylvania Dutch Council Service Center no later than May 8, 2015 or late fees will apply.
=
Total Scouts _____ x $170.00
(6RESC)
Step 2
Total Adults _____ x $100.00
=
Total Adult T-Shirts _____ x $12.00
Number of Shirts by Size: _____ S _____ M _____L _____ XL _____ 2X _____ 3X
=
Total Camp Photos _____ x $8.00
=
Total Family Night Dinners _____ x $8.00
=
Subtract Deposits Previously Paid _____x $25.00
-
Subtract Free Leaders _____ x $100.00
-
(Campers & Guests age 5 & under eat free)
(Attach Copy of Deposit Receipt)
(See back to figure out if you qualify for Free Leaders)
Subtract Total Camperships/Popcorn Prizes
(A copy of the Campership or Popcorn Prize Letter from the PA Dutch Council must be attached to
receive credit)
Step 3
(6RESS)
(6RESP)
(6RESM)
-
Late Fees _____ youth x $25.00
=
Total Fees Due with this transmittal. Submit one Pack check to cover fees.
=
(Apply for any payments turned into Service Center after May 8, 2015)
(6RESC)
Attachments: Use this transmittal form as a cover sheet. Attach Copies of the following to the back:
• Each Individual Information Form
• Required Health Forms (for youth and adult campers)
• Special Dietary Needs Forms
• BMX Pump Track Hold Harmless
• Copies of Campership/Popcorn Prize Letters
• Youth Protection Training for Each Adult
• Copy of Deposit Receipt
*Submit Your Packet by May 8, 2015 or Late Fees Will Apply*
See Back for Further 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
Artie’s Important Information!
This Transmittal form is to be used by the Pack to make final payments for Summer Camp. In order
to avoid Late Fees, this form, all required attachments, and one Pack check made out for the total
amount must be received by the Pennsylvania Dutch Council Service Center on or before May 8,
2015.
INDIVIDUAL REGISTRATION: Cub Scouts planning on attending Summer Camp during either a
different session than the rest of their Den/Pack or in the event that no one else from the Pack is
attending are still welcome to come! In this case, an adult family member (21 years of age or older)
must accompany each Cub Scout. To register as an individual, fill out the Individual Information
Form for the camp and send it directly to the PA Dutch Council Service Center with payment and all
required attachments.
FEES: 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 8. After May 8
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.
FREE ADULTS: For every five boys attending the same camp session, one adult gets to attend Free.
See the Schedule below to determine if you qualify for Free adults.
# of Youth
# of Free Adults
5-9
1
10-14
2
15-19
3
20-24
4
25-29
5
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: All Youth Campers and Adults must have a medical form. No one will be
permitted to stay in camp without the proper medical form. Be sure to make copies before you
come to camp and keep the original in a safe place to use again. If you are unable to attach a copy
of the required medical form at the time of payment bring it to camp with you on check in day. Do
not send it directly to the Council Service Center or directly to Camp Mack. Required medical forms
are as follows:
Cub Scout Day Camp
Cub Scout Resident Camp
Pack Camp
Webelos Resident Camp
BSA Medical Form Parts A & B
BSA Medical Form Parts A & B
BSA Medical Form Parts A, B, & C
BSA Medical Form Parts A, B, & C
FOR FURTHER INFORMATION: For further information please see the 2015 Camp Mack Adult
Guide. The Adult Guide is available online at www.padutchbsa.org/camping/mack.
Pennsylvania Dutch Council 630 Janet Ave. Suite B-114 Lancaster, PA 17601
717-394-4063
www.padutchbsa.org