MISSC Application

Your First and Last Name

Parents' Name

Home Phone and/or Cell Phone

Your Address

City

State MIWI
Zip Code
Birth Date

Gender —Please choose an option—MF

Your Email

Parents Email

Additional Email

Scoutmaster Name

Scoutmaster Email

Troop #
Rank —Please choose an option—ScoutTenderfoot2nd Class1st ClassStarLifeEagle Years at MISSC 01234567
T-Shirt —Please choose an option—SMLXLXXL
MISSC Jacket —Please choose an option—SMLXLXXL

MISSC Hoodie $30.00 —Please choose an option—NoYes
MISSC Hoodie Size —Please choose an option—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)

Mackinac Island Scout Service Camp deposit $125.00 is due now. Also all full payments are paid online. We have a paypal account through Nookaa Media (Patty's Account), if you have a paypal account you can use your account, and Nookaa Media paypal account also accepts Credit and Debt cards.

We will be attending the Mackinac Island Scout Service Camp at Fort Mackinac from May 30 to June 6, 2026. You will be notified by email if accepted. If not accepted, your deposit with be refunded.

SCOUT AGREEMENT

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