Resident Permit Application

Resident's Name*

First Last

Resident's Organization (if appropriate)

Address*

Street Address Municipality City State ZIP Code

Home Phone Number*

Cell Phone Number

Fax Number

Arrival Date*

Departure Date*

Lean-to

No.1
No.2
No.3
No.4
Troop 9
Yeoman’s

Campsite

NE
South
East
West

Special Permission Request(s)

Special Permission Request(s)

Explain Special Permission Request(s)

Lion’s Den

Lion’s Den

Priority is given to groups of 20 or more. If not in use the Lion's Den is available to all.

Number of Persons: Youth under 18

Number of Persons: 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.