Camp Fire USA: Snohomish County Council; Club Camping Form

Application for Club Camping

Destination:

Date(s) of Event: # Youth # Adults # Total

Program Level(s): Starflight Adventure Discovery Horizon

Name of Leader:

Address: City: Zip:

E-mail Contact Address:

Name of adult in charge:

Address: City: Zip:

Name of person having completed Outdoor Training.
(see club camping standards I, personnel A)
Phone:

Name of person with current first aid certificate, LPN or RN
Phone:

Is waterfront activity planned? Yes No If yes, name of person in charge?
(see club camping standards I, personnel A)
Phone:

List of other adults who will accompany your group
(see club camping standards I, personnel D)
Phone:
Phone:
Phone:
Phone:

If you are using private property, has written permission been obtained: Yes No
(see club camping standards III, administration G)

Do you have written permission from the parent or legal guardian of each youth member to participate in the group camping event? Yes No
(see club camping standards III, administration A & C)

Do you agree that your group has read the Club Camping Standards and has agreed to comply with them? (You can find these standards in your leaders manual or outdoor training manual.) Please type your name as your signature and agreement:
Date:

Complete the following if your group is applying to use Camp Killoqua. Otherwise skip this section and press the submit button.

If coming to Camp Killoqua: A user fee of $25 per night per club must be paid before this application is accepted.

In case of cancellation, the Camp Fire Training and Resource Center must be notified five days in advance in order for a refund to be issued. No refunds if less then five days notice is given.

Check-in is after 4pm of the day requested. Check-out is 4pm of the day requested. Early arrival and late departure may be possible but cabin space assigned may not be available during these extensions.

Arrival Time: Departure Time:

Building Desired: Tell us where you would like to be. If these options are not available we will contact you to help you choose from what is available.
1st choice:
2nd choice:
3rd choice:

Do you agree that your club will guard against the destruction of camp property, assume financial responsibility for any damaged, defaced or destroyed facilities and/or equipment, and be responsible for any injuries to persons in camp?

Please type your name as your signature and agreement:
Date:

To pay by cash, check, or money order
Print this page and include it with your payment. Mail it to the address above, or drop it off in person. Please do not click "submit," as this will duplicate your registration.

I agree and consent to the taking and use of any photograph of my child or myself by Camp Fire USA and waive any claims of compensation for such use or damage.
Signature: ______________________________________________________________

To pay by Visa, Mastercard or Camp Fire Candy Currency
Press "submit" and complete the payment page. Be sure to press "purchase" when done!
By pressing "submit," I agree and consent to the taking and use of any photograph of my child or myself by Camp Fire USA and waive any claims of compensation for such use or damage.