MISSC Application Mackinac Island Scout Service Camp 2017 Application Your First and Last Name Parents' Name Home Phone and/or Cell Phone Your Address City State MIWI Zip Code Birth Date Your Email Parents Email Additional Email Scoutmaster Name Scoutmaster Email Troop # Rank ScoutTenderfoot2nd Class1st ClassStarLifeEagle Years at MISSC 01234567 T-Shirt (required) SMLXLXXL MISSC Jacket $25 YN ---SMLXLXXL (Optional) Hoodie $25 YN ---SMLXLXXL Why do you want to attend MISSC and what do you hope to gain from it? (You can pull the text box to make it larger while typing) If you are interested in a leadership position (SPL, ASPL, PL, APL or Flag Commander), please use the following spaces to (1) indicate the position you would like; (2) what experiences you have for this position; and (3) why you feel you are the best Scout for this position. (You can pull the text box to make it larger while typing) Please send $100 deposit by February 18, 2017 to Mackinac Island Scout Service Camp, P.O. Box 845, Escanaba, MI 49829. Make checks payable to Troop 411, MISSC. We will be attending the Mackinac Island Scout Service Camp at Fort Mackinac from June 3 to 10, 2017. You will be notified by email if accepted. I hereby certify all information on the form is correct and that a copy of a Scout physical form will be completed and signed by a doctor prior to attending the Mackinac Island Scout Service Camp. The Scout promises to live by the Scout Oath and Law while at Mackinac Island. In cases of extreme misbehavior, the Scout will be fully responsible for the cost of return transportation. I understand that during the stay at camp there may be photos, voice recordings or video taken and I hereby consent to the use of my son's voice and/or photograph in the news coverage, camp or council promotional CD's or movies, on the council approved website or similar projects approved by this council and by the Boy Scouts of America. I AGREE   Please contact Scoutmaster Craig Woerpel with any questions you have in registering your scout at 906-280-0936 or by email.