Camp Bob Hardin 2017 Sign-Up
This is to sign up for Boy Scout summer camp at Camp Bob Hardin, June 18 - June 24, 2017. Please fill out this form as completely as possible. If you need to change information, you can modify your response. If you would like to withdraw, please email Donna-Jean Keim directly @ donna-jean@ikeim.com

The Leader's Guide contains information about the Merit Badges being offered. Merit Badge registration should be completed in addition to this form by February 20, 2017, if possible.

Scout First Name *
Your answer
Scout Last Name *
Your answer
Current rank *
Some merit badges have rank/age requirements.
Birthdate *
MM
/
DD
/
YYYY
Age as of 6/18/2017 *
Scout email address *
Please type "none" if you don't have one.
Your answer
T-shirt Size (Adult sizes) *
Parent 1 Name (Last, First) *
Your answer
Parent 1 email *
Your answer
Parent 1 Cell (Please include dashes.) *
Format 555-555-5555. Please type "none" if none.
Your answer
Parent 2 Name (Last, First)
Your answer
Parent 2 email
Your answer
Parent 2 Cell (Please include dashes.)
Format 555-555-5555. Please type "none" if none.
Your answer
Home Phone *
Format 555-555-5555. Please type "none" if none.
Your answer
Emergency # *
Your answer
Street Address *
Your answer
City *
Your answer
Zipcode *
Your answer
Medications Needed *
If unsure, please check "possibly". This will be revisited closer to the camp.
Required
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