Camp Site Rental Agreement Form
Camp Pioneer – Beverly, WV

*Pricing is changing for 2021. Please call 304-636-3638 or email for updated pricing.

Contact Information
Today's Date*
Date Format: MM slash DD slash YYYY
Check-In Date*
Date Format: MM slash DD slash YYYY
Name of Guest or Organization:*
Contact Person:*
Position:*
Mailing Address:*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Primary Phone:*
Secondary Phone:
Email:*
Preferred Method of Contact:*
- Email
- Phone
- Mail
Vehicle Description
Year:*
Make:*
Model:*
License:*
Camp Site Rate Schedule:
Primitive Campsites (Car or Tent Camping; No utilities) - $15/night

Water & 30 AMP Electric Campsites - $25/night; $150/week; $550/monthly

Water, 30 AMP Electric, & Sewer Hook Up - $25/night; $150/week; $550/monthly

Water & 50 AMP Electric - $25/night; $150/week; $550/monthly

*Camp Pioneer reserves the right to adjust the rates within 60 days.
Special Requests:
Camp Site Rental Rules:
- All campers must check-in, present a copy of valid drivers license and pay for the site prior to hooking up to utilities, unless the site is pre-paid.
- Free Wi-Fi is available. Cell phone service is available through US Cellular, AT&T, and Ntelos.
- Quiet Hours are enforced between 10 PM and 7 AM. No generator use during this time.
- No smoking at any time in any building.
- Pets must be kept contained at the camp site. Pets may not be left unattended. Clean up after pets and dispose of waste in trash cans.
- Sites are assigned on a first come, first served basis and taking into consideration type of hook-up and special requests such as access for disabled guests.
- Fires permitted in designated fire rings only. Fires may be restricted during certain seasons. Please check with the Camp Manager.
- Extended stays (beyond 7 days) require full water and sewage hook up.
- Firewood may be purchased from the Camp Caretaker or Camp Manager.
- Occupants must maintain the cleanliness of their site and ensure that all refuse is in its appropriate container.
- Absolutely no ATV's or off road vehicles permitted without appropriate RCPRB written permission.
- Background checks and random drug testing may be required for all applicants.
- For emergencies, contact 911. For the Camp Manager, contact (304) 621-3638.
- 100% Pre-payment is required to secure camp site rental.
- Cancellations must be received 7 days prior to the arrival date to avoid a loss of 50% of the rental fee.
- Cancellations must be submitted in writing to the Camp Manager.
- Make check payable to Randolph County Park and Recreation Board.
Fees
Total Rental Fees:*
Received By:*
Paid By:*
- Cash
- Check
Check #*
The Randolph County Park and Recreation Board, it's employees or board members will not be liable for injury, or personal articles, lost, damaged or stolen.
Print Name of Renter*
Signature of Renter
Date
Date Format: MM slash DD slash YYYY

Camp Site Rental Agreement Form Camp Pioneer – Beverly, WV

Contact Information

Vehicle Description

Camp Site Rate Schedule:

Camp Site Rental Rules:

Fees

Camp Site Rental Agreement Form
Camp Pioneer – Beverly, WV