the 2016 Hold-A-Place form! - Blue Ridge Mountains Council

Blue Ridge Scout Reservation
Boy Scouts of America, Blue Ridge Mountains Council|www.bsa-brmc.org/summercamp
HOLD A PLACE FOR 2016
Phone: 540.777.7963|e-mail: [email protected]|Fax: 540.265.0659
Unit Type: ____ Troop ______ Crew
Unit Number: ___________ Charter Organizaiotn: __________________________
Council: ________________________
District: _______________ Council HQ City: _______________________________
We are pre-registering this number of Scouts & adults to attend the following camping program(s) (Including Webelos crossing over into Boy Scouts). The Completion and submission of this form constitutes a legal and binding contract.
Camp Powhatan
+Brownsea Island Scouts
# Scouts
# Leaders
*xNew River Adventure *Voyageur Trek
# Scouts
# Scouts
# Leaders
# Leaders
Camp Ottari
+Brownsea Island Scouts
# Scouts
# Leaders
*Mountain Man
# Scouts
# Leaders
*Claytor Lake Aquatics Base
# Scouts
# Leaders
*Wakeboarding
# Scouts
# Leaders
*High Knoll Trek
# Scouts
# Leaders
*SCUBA
# Scouts
# Leaders
Go to www.BSA-BRMC.org/SummerCamp for a
description of all the programs and camps.
*Fish Camp
# Scouts
# Leaders
*Advanced SCUBA
# Scouts
# Leaders
*NYLT
# Scouts
# Leaders
NYLT not offered all weeks;
please call for schedule.
NOTES:
*Adult leaders NOT required for these programs.
× NEW RIVER ADVENTURE PARTICIPANTS ARE HOUSED AT CAMP POWHATAN.
+Brownsea Island is for Scouts that have just crossed over from Webelos or are 11-13 and have no prior experience in
Scouting; the program is available at both Powhatan and Ottari Base Camps.
Indicate Camp Date:
Week 1- June 12-18 _____________
Week 2- June 19-25 _____________
TOTAL
# Scouts
Week 3- June 26- July 2 __________
Week 4- July 3– 9
_____________
# Leaders
Week 5- July 10-16 _____________
Week 6- July 17-23 _____________
Week 7- July 24–30 _____________
HOLD A PLACE FOR SUMMER CAMP: $100 site deposit is due at application and is applied to the balance of fees in June.
2016 Camp Fees are subject to change.
The $100 deposit is fully refundable until December 31, 2015. It is NOT refundable if your Troop cancels after this date.
Please complete the next page and save this document.
© 2015 BRMC
All Blue Ridge Scout Reservation Camps and Programs
are accredited through the BSA NCAP Program
Fee Schedule:
Youth
Adult Leaders
February 1 Payment of $100 per youth is due Feb. 1, 2016. If not
received by Feb. 15, 2016, the reservation will be cancelled.
Payment of $100 per adult leader is Due by Feb. 1, 2016.
If not received by Feb. 15, 2016, the reservation will be
cancelled.
April 1
An additional payment of $100 per youth is due by April
1, 2016. After April 1, these fees are non-refundable, and
non-transferable. Failure to submit payment by April 1,
2016 will result in cancellation of your reservation.
For adults attending base camps Ottari or Pohwatan, an
additional $75 is due on April 1, 2016. For all other programs, an additional payment of $100 is due by April 1,
2016. After April 1, these fees are non-refundable, and
non-transferable. Failure to submit payment by April 1,
2016 will result in cancellation of your reservation.
June 1
Balance of fees is due. If paid after June 1, 2016, a $25 per person late fee will be charged.
Additions and Cancellations:
Always check with the Camp Registrar (540.777.7963) before adding youth or adult leaders. Most weeks are at capacity and
have a waiting list for available space. To cancel reservations or to change numbers of people attending, written notification is
required to our Camp Registrar, Shirley Neiderhiser, (email [email protected].) Cancellation of any reservation between
April 1st and June 1 will result in a $200 per person cancellation fee ($175 cancellation fee for adult leaders attending base
camps Ottari or Powhatan). Cancellations After June 1- No Refunds (See Below).
Refund Policy:
In cases of death of an immediate family member, sickness or injury, or military transfer, we will refund all but $100 of fees
paid when verified by a physician, military commander, or such official. The Blue Ridge Scout Reservation strives to provide
the very best program. We sign contracts with staff and vendors in February. Reservation cancellations after April 1 undermine our ability to provide this quality program. Reasons such as vacation schedule, summer school, and last minute changes
of mind are not acceptable reasons for refunds.
Agreement:
I understand and accept the fee schedule and refund policy stated and want to make a reservation to attend the Blue Ridge
Scout Reservation in Summer of 2016.
Date: ______________________
Committee Chair Name: ________________________________________________
Daytime Phone: _________________________ e-mail: __________________________
Mailing Address for Billing, Passwords, Communications:
Scout Camp Coordinator Name: ________________________________________
Daytime Phone: _________________________
e-mail: _______________________________
Mailing Address: _______________________________________________________________________________________
City: ______________________________ State: ___________ Zip: __________________________
Alternate Scoutmaster (For communication if the above leader cannot be contacted:
Name: ___________________________________________ Daytime Phone: ____________________ e-mail: _______________
Hold-A-Place Deposit of (amount) $__________________________ may be paid by: ___MasterCard ____Visa ____Discover ___Troop Check
Account #:____________________________________________ Exp Date:__________________ Card Name:__________________________________
Rules for acceptance and participation in all these programs are the same for everyone without regard for race, color, national origin, or disabilities.
Please return this completed form to confirm your reservation: save the completed form, then attach to email to [email protected]. Fax to 540.265.0659. Mail to:
Boy Scouts of America, Blue Ridge Mountains Council, P.O. Box 7606, Roanoke, VA 24019.