Central New Jersey Council
Cub Scout Day Camp
Den Chief Application

NOTE: Each Den Chief applicant must be registered in a Troop in the Central NJ Council.
Submission of application does not guarantee placement as a Den Chief.

Youth Name:
Youth Birthdate:

/ / (mm/dd/ccyy)

Street Address:
Parent Email:
City:
, NJ
 
Zip:
(xxxxx-xxxx)
Home Tel:
Troop or Crew #:
Rank:

Troop Leadership
Positions Held:

Check all leadership positions that the Youth has held.

Chaplain Aide Instructor Troop Guide
Asst. Sr. Patrol Leader Librarian OA Representative
Sr. Patrol Leader Quartermaster Bugler
Jr. Asst. Scoutmaster Scribe Webmaster
Patrol Leader Den Chief Leave No Trace Instructor
Asst. Patrol Leader Troop Historian Musician
Does the Youth have any physical limitations that might affect his/her ability to function at camp? Yes No If yes, explain here:
       
Select Day Camp Location:    
Previous Day Camp Experience:

Yes No

If yes, how many years?

If yes, list previous Day Camp positions:

:

 

Other Skills:
       
Free Tee-Shirt:

As a Den Chief, you will receive one free
tee-shirt. Please indicate your shirt size.

Additional Tee-Shirts:

Additional tee-shirts can be purchased for $10 each.

Select number of additional tee-shirts

       
Press "Validate Entries" button before proceeding -->
Total Cost of Extra Tee-Shirts->

My son/daughter is in good physical condition and agrees to work at camp. He/she will provide required medical information on the first day of camp. He/she understands that a den chief's appearance must at all times reflect the good taste and Scout-like image which is expected of those who represent CNJC. All statements on this application are true, and I authorize the Central New Jersey Council, BSA to confirm all supplied information. By signing this application I acknowledge that I agree with the procedures and policies of the Central New Jersey Council, BSA, including but not limited to the health services. I also, hereby consent to the use of my son's/daughter's voice and/or photographic image in any news coverage, movie making, or similar

Council Refund Policy: There are no refunds for any activity, training, or program whose on-time individual fee is $10 or less.

Electronic Signature:

1- Check this box to confirm you have read the refund policy and agree to the statements above.

2- Parent/Guardian's Signature:

After signing, press the "Send" button once

February 16, 2010 03:00 PM