PARENTS PACKET For KAMP KAPPA July 22-27, 2012 Reggie L. Bullock Kamp Kappa 2012, Chairman Kappa Scholarship Endowment Fund, Inc. KAPPA ALPHA PSI FRATERNITY, INC. ALEXANDRIA-FAIRFAX (VA) ALUMNI CHAPTER 6343 South Kings Highway, Alexandria, VA 22306

ALEXANDRIA-FAIRFAX (VA) ALUMNI CHAPTER Kappa Scholarship Endowment Fund, Inc. Kamp Kappa Youth Development Program APPLICATION KAMP KAPPA 2012 July Date Received_________ Application #_____ Your Kappa Sponsor Name and Number __________________________________ CHILD’S NAME_____________________________ AGE_________ DATE OF BIRTH___________ ATTEND KAMP KAPPA Before? NO ___ YES___ ADDRESS_______________________________________________ CTY________________________ STATE____________ZIP CODE________ SCHOOL NAME_______________________CITY__________________ ADDRESS _________________________________GRADE______ Please X for T-Shirts size S___ M___ L___ XL__XXL___ XXXL___ Other___ PARENT/GUARDIAN NAME__________________________________ BUS PHONE________HOME PHONE ___________CELL PHONE_________ PARENT/GUARDIAN NAME________________________________ BUS _________________HOME PHONE ___________CELL PHONE_______ EMERGENCY CONTACT NAME__________________ Phone__________________ Note: Application due ASAP. Medical information due May 31, Please bring all medication, to the registration. (July 22, 2012) or Mail information to: Reggie Bullock, Capstan Drive, Upper Marlboro Maryland or Fax POC: Reggie Bullock

What is your favorite thing to do outside?__________________________________________ What is your least favorite thing about the outdoors?_____________________________________ Who is your role model and why?____________________________________________ Camper ’ s Name____________________________________Nickname___________________ Grade you are going into________ School__________________________________________ Favorite Subject___________________ Least Favorite Subject_____________________ What is the first thing you do when you get home from school?____________________ ______________________________________ What sports do you like to play?______________________________________________ Are there any clubs or organizations that you are a member of?_____________________ Do you have any brothers/sisters? If so how many?______________________________ Do you have any pets? If so, what do you have? ________________________________ Have you been to Kamp Kappa before? If so when?______________________________ What are you excited about doing at Kamp?____________________________________ Is there anything about Kamp that you don ’ t want to do?___________________________ What is your favorite thing to do outside?______________________________________ What is your least favorite thing about the outdoors?______________________________ Who is your role model and why?____________________________________________ Kamp Kappa Camper Information Please take the time to fill out the questions below. It does not matter how much or how little you write, but be sure to answer every question.

ALEXANDRIA-FAIRFAX (VA) ALUMNI CHAPTER Kappa Scholarship Endowment Fund, Inc. Kamp Kappa Youth Development Program Camp information If you're looking for a great adventure...it starts at Camp William B. Snyder!!! The 350-acre Camp William B. Snyder, located in Haymarket, Virginia is the latest and greatest camping experience offered by the National Capital Area Council and the Boy Scouts of America. Camp Snyder, now operating in our 3rd year serves as a multi-functional camp that can meet the needs of Packs, Troops, Venture Crews, Varsity Teams, and other outside organizations looking to develop a partnership or quality outdoor experience.

Yes this is where we will be sleeping ALEXANDRIA-FAIRFAX (VA) ALUMNI CHAPTER Kappa Scholarship Endowment Fund, Inc. Kamp Kappa Youth Development Program

KAMP KAPPA Directions to Camp Directions to Camp William B. Snyder Directions to Camp William B. Snyder 6100 Antioch Road, Haymarket, VA ( ) Interactive Map From the east (Capital Beltway - Route I-495): Take Interstate 66 west to exit #40 (Route 15). Travel south on Route 15 to the second traffic light and turn right onto Route 55 (John Marshall Hwy). Travel west about 1 mile to Antioch Road. Turn right onto Antioch Road and follow sign to Camp Snyder. From the south: Travel north on Route 15 (Warrenton), Route 7100 (Fairfax County Pkwy) or Route 28 (Manassas) to Interstate 66. Travel west on Interstate 66 to exit # 40 (Haymarket, VA). Travel south on Route 15 to the second traffic light and turn right onto Route 55 (John Marshall Hwy). Travel west about 1 mile to Antioch Road. Turn right onto Antioch Road and follow sign to Camp Snyder. From the north: Travel south on Route 15 (Leesburg), Route 28 (Sterling) or Route 123 (McLean) to Interstate 66. Travel west on Interstate 66 to exit #40 (Haymarket, VA). Travel south on Route 15 to the second traffic light and turn right onto Route 55 (John Marshall Hwy). Travel west about 1 mile to Antioch Road. Turn right onto Antioch Road and follow sign to Camp Snyder.

KAMP KAPPA Directions to Camp Application

KAMP KAPPA Points of contact Reggie Bullock Norman Simon Clifton Taylor