/ Camp Samac – Facility Booking Form 2012
Category C: Third Party (Non Youth Users)
E-Mail address:
Organization Name: / Total # attendees:

Arrival/Departure Information:

Arrival Date (dd/mm/yy): / Time:
Departure Date (dd/mm/yy): / Time:
Individual In Charge (On site while at Camp):
Name: / Cell Phone
Position in SC/GGC: / Home Phone
E-mail / Work Phone
Individual Making Reservation:
Name: / Phone
E-mail

A: Camp Facilities (Camp Samac – Oshawa Site)

q Admin Bldg / Boardroom (35’x30’)
Tables & Chairs for 30 / $60 – each 4 hrs
$175 all day
q Admin Bldg / Training Room – Lower Level
Tables & Chairs for 20 / $60 – each 4 hrs
$175 all day
q Council Hall / 2 rooms – capacity 130 & 160
Kitchen (2 gas stoves, 2 door fridge, 3 sinks
Washrooms, tables and chairs available / Date: ______Time: ______
$225 – 4 hrs
$405 – 8 hrs
$1215 - Weekend
q Kitchie Lodge / Capacity 80, 20 + 20 east side, 20 + 20 west side
2 stoves, 2 fridges, 3 sinks
Washrooms with showers, handicap accessible / $345 – 9 am – 4 pm
$230 – 6 pm – 10 pm
$460 – Weekday overnight
$1715 – Weekend
q Cabin 1 / Capacity 30, 14 + 14 upper level, 1 bunk main level
2 stoves, 2 door fridge, 3 sinks
2 washrooms / $220 – 9 am – 4 pm
$140 – 6 pm – 10 pm
$290 – Weekday overnight
$805 – Weekend
q Cabin 2 / Sleeps 18, 16 main room, 1 bunk separate room
Stove, fridge, 3 sinks
2 washrooms (1 handicap accessible) / $175 – 9 am – 4 pm
$115 – 6 pm – 10 pm
$175 – Weekday overnight
$575 – Weekend
q Cabin 3 / Sleeps 18, 16 main room, 1 bunk separate room
Stove, fridge, 3 sinks
2 washrooms / See rates as per Cabin 2
q Cabin 4 / Sleeps 18, 16 main room, 1 bunk separate room
Stove, fridge, 3 sinks
2 washrooms / See rates as per Cabin 2
q Cabin 5 / Rustic Cabin
Sleeps 20, 1 room cabin
Stove, fridge, 3 sinks, washroom / See rates as per Cabin 2
q Cabin 6 / Rustic Cabin
Sleeps 20, 1 room cabin
Stove, fridge, 3 sinks, washroom / See rates as per Cabin 2
q Cubland / Sleeps 38, 12 main floor, 26 lower floor
(3 rooms for 4, 8, 14)
2 stoves, 2 door fridge, 3 sinks
3 washrooms / $230 – 9 am – 4 pm
$145 – 6 pm – 10 pm
$320 – Weekday overnight
$910 – Weekend
q Staff Cabin 2 / Sleeps 12 (8 + 4)
Stove, Fridge, 3 sinks, washroom
Located on south-west side of camp
****Water NOT available December to April / $90 – Weekday overnight
$345 – Weekend
q Lakeland / Tenting area
10 Sites available each holds 20 campers
Located behind Kitchie / To be determined with contract/PM
q Beaver Meadow / Program Activity Area
Located southeast of creek / To be determined with contract/PM
q Rec Field / Program Activity Area
Located across from Cubland / To be determined with contract/PM
q Fire Pit / Evening rental
q Beaver Meadow q Rec Field / $25
q Evening Hike / $25
q Washroom / Preferred location: / $25

B: Facilities (Adventure Base – Haliburton Site)

q Trading Post / Sleeps 36 (26 + 6 + 6 + 4)
Electricity, wood stove, outdoor KYBO / $268 per weekend
q Tenting / Fields / To be determined with contract/PM

C: Crests: Camp crests available from warden $2.00 each # Crests being requested:

D: Deposit and Final Payment – 10% deposit required, balance due 30 days prior to arrival date

q Cheque Cheque #: ______Bank: ______

q Credit Card Type (MC/Visa): ______CC #: ______

Expiry Date – Month/Year: ______

Signature: ______

**********

The deposit MUST accompany your booking in order to secure reservation.
Booking is secured once you receive confirmation from the Camp Administrator.

Return to: Scouts Canada, WPC Camp Administrator, 1711 Simcoe Street, Oshawa, ON L1G 4Y1
email: Fax: 1-905-571-7920

Billing Information (To be completed by Office)

Facilities Reserved / Cost / Method of Payment
Facility 1
Facility 2 / Cheque / Cheque #:
Facility 3 / Credit Card / Type (MC or Visa):
Facility 4 / Credit Card #:
Extras / Expiry Date - Month/Year:
SUBTOTAL A =
(Payment Method – if by Credit Card) 2%
SUBTOTAL B = / Amount / Date Paid
13% HST / 1st Payment
TOTAL = / 2nd Payment

Phone: 1-905-571-1346 Ext 23 Fax: 1-905-571-7920 E-mail: Revised September 2012

Samac-annual-bookings-forms