Professional Documents
Culture Documents
Registration will not be accepted without a completed Annual Health and Medical Record:
Scouts Name_________________________________________________Age___________
Address_________________________City_____________________State______Zip_________
Pack#______District______________Email__________________________________________
Additional Shirts $10 _____ (one complimentary youth shirt is included with registration)
Youth T-shirt Sizes: YS_____ YM_____YL_____AS_____AM_____AL_____
Adult T-shirts: AS______AM_____AL______XL______2X_______3X______
Additional Shirt for: Adventure Camp Adventure Weekend Webelos Adventure Weekend (circle )
Swimming Permission: (Check One) * Pontiac, Bloomington, Princeton Adventure Camps; Timber
Pointe and Ingersoll Scout Reservation Adventure Weekends.
____Beginner (Shallow Water only) ____ Swimmer ____ My child is not permitted to swim
Please make checks payable to W. D. Boyce Council For Office Use only:
and mail with registration and health forms to:
W. D. Boyce Council Date Received:______ Health Record:______
614 NE Madison Ave
Peoria, IL 61603 Notes:________________________________
2017 Cub Scout Camping Registration
Registration will not be accepted without completed Annual Health & Medical Record: Parts A & B must be
completed by every youth and adult.
Adventure Camp: Date and Time Volunteer Camp Early Bird Due EB cost is $100 per Total Cost
Open to all Cub Scouts Director Dates youth on/before due
Tigers through Webelos date. Regular cost is
$125 per youth.
Canton June 5 to 9 Mike Charlesworth
Youth Acres 8:30am to 4:00pm (847) 997-1200 May 5th ____Scouts @$_____ $_____
Princeton June 5 to 9 Theresa Sartain
City Park 8:30am to 4:00pm (815) 252-6678 May 5th ____Scouts @$_____ $_____
Pontiac June 12 to 16 Dave Gallup
Humiston Woods 8:30am to 4:00pm (815) 674-5825 May 5th $_____
____Scouts @$_____