Reservation request form 2024

2277 Executive Drive, Lexington, KY 40505

859-293-2621800-475-2621

Reservation Request Girl Scouts of Kentucky's Wilderness Road Camps

To reserve a unit/facility at one of our camps you must fill out this form. You may pay by check by mailing it or bringing it to the Lexington Shop with this form. Or you can pay by credit card by calling or stopping by the Lexington Shop. NOTE: Cancellation of your reservation 3 weeks or less will result in the loss of your deposit. The site rental fee will be processed upon receipt. For day use events and overnight events, a $50 deposit check must be attached to hold your reservation. The deposit check will be cashed in the event of damage and/or not resupplying paper products. The deposit will be shredded after checkout procedures are complete and if the camp site is in appropriate condition. If fees are not paid at least two weeks prior to the reservation, the reservation will be cancelled.
Name/Type of Event
Name of Troop Leaders/Person (People) in Charge
Troop Number/Group Number/Name of Group
Number of attending Girl Scouts
Number of attending Female Adult Girl Scouts
Number of attending Non-Registered Girl Scout youth or adult Participants
Program Grade Level (check all that apply):

Daisy (grades K-1)Brownie (grades 2-3)Junior (grades 4-5)Cadette (grades 6, 7, 8)Senior (grades 9-10)Ambassador (grades 11-12)Adult
Person in charge's Address

Address

Street Address Line 2

CityState

Zip
Phone
Email Address
example@example.com
Name adult/adults with the following trainings:
Out-n-About Trained Person
Date Completed

MonthDayYear
Date
Troop Camp Certification Trained Person
Date Completed

MonthDayYear
Date
First Aid/CPR Trained Person
Date Completed

MonthDayYear
Date
Indicate preference for camp and facility. Give first and second choices.
First Choice Camp Name and Facility(ies) (Unit)
Arrival DateTime

MonthDayYear
Date
Departure DateTime

MonthDayYear
Date
Second Choice Camp Name and Facility(ies) (Unit)
Arrival DateTime

MonthDayYear
Date
Departure DateTime

MonthDayYear
Date
For overnight camping, check-in time is 4:00 p.m. and check-out time is 3:00 p.m. *No Staff are onsite. Please text or call 859-490-0619 to check in and out.*
Equipment requested
Signature

Clear
Date

MonthDayYear
Date
Site Manager Site Check Completed Date

MonthDayYear
Date
Please list any Non-Registered attendees and their age(s)
Should be Empty: