CSR 2020 | Provisional Registration Week 1 (June 21 - 27)
Use this form to register for the Provisional Unit at Cherokee Scout Reservation.

The Provisional Unit is open to female and male Scouts.
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Scout Information
Scout's First Name *
Scout's Last Name *
Scout's BSA ID
Scout's Date of Birth *
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/
LL
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AAAA
Scout's Gender
Scout's Unit Type *
Scout's Unit Number *
Scout's District Name
Scout's Council Name *
Parent/Caretaker Information
Parent/Caretaker 1's First Name *
Parent/Caretaker 1's Last Name *
Parent/Caretaker 1's Cell Number *
Parent/Caretaker 1's Email Address *
Parent/Caretaker 2's First Name
Parent/Caretaker 2's Last Name
Parent/Caretaker 2's Cell Number
Parent/Caretaker 2's Email Address
Emergency Contact Information
Please list the name of an emergency contact other than a parent or primary caretaker.
Emergency Contact's First Name *
Emergency Contact's Last Name *
Emergency Contact's Cell Number *
Special Needs Information
In this space please describe any special needs the Scout may have. They might include but are not limited to dietary, medical, physical, or cognitive needs.
Unit Leader Information
Please provide the name and email address of your Scout's unit leader. We will use this information to share your Scout's advancement report with the unit. We will email the unit leader a copy of your Scout's merit badge completion report on the Saturday your Scout departs summer camp.
Unit Leader's First Name *
Unit Leader's Last Name *
Unit Leader's Email Address *
Payment Information
You can submit your payment three ways.

The preferred method is to pay using a credit card online. If you select this option, we will send you directions on how to pay using a secure Parent Payment Portal in our merit badge registration system - Summer Camp Systems.

You may also submit a check made payable to Old North State Council, 1405 Westover Terrace, Greensboro, NC 27408

Or, you can pay in person at the Old North State Council Office, 1405 Westover Terrace, Greensboro.
How do you plan pay? *
By attending this week of camp with the Provisional unit, will your Scout be a multi-week camp for 2019? If Yes, what other week(s) will your Scout attend camp at Cherokee? *
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