Camp Wyanokie Non-Resident Permit Application

Caldwell, Fairfield, North Caldwell, Roseland and West Caldwell

Arrival Date:

Departure Date:

Facilities Requested:

Lean-to:

No.1

No.2

No.3

No.4

Troop 9

Yeomanís

Campsite:

NE

South

East

West

Special Permission Request(s)

Lionís Den

Priority is given to groups of 20 or more. If not in use it is available to all.

Number of Persons:

Youth under 18

Adults

In connection with submission of this application I hereby acknowledge that I have read the Rules and Regulations governing the use of Camp Wyanokie and agree to abide by them.

Additionally, I and all members of my group agree to hold Camp Wyanokie harmless from any and all claims for damages which might arise from the exercise of privileges granted for the uses of Camp Wyanokie.

Date:                                  Signature:                                   

Overnight Camping: $10.00 Registration Fee per permit plus $5.00 per person per night

Day Usage: $10.00 Registration Fee per permit plus $5.00 per person

NON-RESIDENT INDIVIDULES & ALL ORGANIZATIONS INSURANCE REQUIREMENTS

Hold Harmless Agreement

Certificate of Insurance

Tour Permit

Your certificate of insurance must show a minimum of $500,000 per occurrence, bodily injury and/or

property damage liability and should name Camp Wyanokie as an additional insured.

Application Approval ( )            Use Permit - Camp Wyanokie Commission

    By:                                                    Date:Fee Received ( )

    Fee Received ( )                              Amount: