2026 Cub Scout Day Camp- Mulberry District
June 6-6, 2026
Cub Scout's Name
*
First Name
Last Name
Scout's grade in Fall of 2026
*
Please Select
1st
2nd
3rd
4th
5th
Scout's Gender
*
Boy
Girl
Scout's shirt size
*
Please Select
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Scout's Age
*
Pack Number
*
District (if known)
*
Please Select
Arrowhead
Cheaha
Cherokee
Choccolocco
Etowah
Mountain Lakes
Mulberry
Sequoyah
Shelby
Three Rivers
Talakto
Vulcan
Westmoreland
++ScoutReach++
++++UNKNOWN++++
Do you have a hiking stave?
*
YES
NO
I need a replacement
Parent/Guardian Name
*
First Name
Last Name
Primary Phone Number
*
Please enter a valid phone number.
Cell Phone Number
*
Please enter a valid phone number.
Work Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Will you work as a Volunteer?
YES
NO
Emergency Contact Information
*
Name
Cell Phone
Contact #1
Contact #2
Contact #3
Adults NOT AUTHORIZED to take youth to and from Camp:
*
SUPPLEMENTAL HEALTH INFORMATION
Camp Health Officer MAY ADMINISTER:
Benadryl
*
YES
NO
Tylenol
*
YES
NO
Advil
*
YES
NO
If your child will require regular medication at camp it is to be turned in to the Health Officer each day at the beginning of Day Camp in its original container with its instructions. Exceptions to this include certain medications, such as inhalers or EpiPens, that need to be with the child.
Other Medications:
Eg. Inhalers, EpiPens, etc.
Does your child have any mobility issues or concerns?
*
YES
NO
Please elaborate on the mobility issues or concerns
Does your child have or require any special needs or provisions our staff should be aware of?
*
YES
NO
Please elaborate on the special needs or provisions we should be aware of
I accept the above information and grant the Camp Health Officer permission to treat my Scout for minor medical issues.
*
YES
NO
Registration
*
prev
next
( X )
(982) Mulberry District Day Camp
For registrations prior to May 1, 2026
$
40.00
(982) Optional Youth T-shirt
$
10.00
Size
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
X Large
Quantity
1
2
3
4
5
6
7
8
9
10
Payment Methods
Credit Card
Apple Pay
After submitting the form, you will be redirected to Apple Pay to complete the payment.
Google Pay
After submitting the form, you will be redirected to Google Pay to complete the payment.
Submit
Should be Empty: