Scout Name:
Parent Attending This Event
Yes
No
Scout Phone Number:
Scout Email:
Patrol:
Alligators
Badgers
Cobras/Squirrels
Dragons
Falcons
Flaming Arrows
Fox
Nightwolves
Owls
Panthers
Scorpions
Venturers
Adult
Rank:
Scout
Tenderfoot
Second Class
First Class
Star
Life
Eagle
Adult Leader
Parent Name:
Parent Phone Number:
Parent Email Address:
Parent Cell Phone # (for emergencies)
Can parent/guardian drive for this trip?
YES
NO
Total # of seat belts (including driver:
1
2
3
4
5
6
7
8
9
Driver leaving with Car Pool?
YES
NO
If you are driving, have you completed a Drivers Survey form?
YES
NO
Number of Individuals (Scouts & Adults) Camping Only @ $27.00 each:
1 @$27.00
2 @$54.00
3 @$81.00
Number of Individuals (Scouts & Adults) Camping + Climbing @ $90.00 each:
1 @$ 90.00
2 @$180.00
3 @$270.00
Please enter the Total Amount Due
My health form is completed or is up to date:
Yes
No
Special Travel Notes:
Payment Type - Due by Wednesday, September 3, 2008
Cash
Scout Account
Check
Home Page
Online Registration Form
Blue Mounds State Park, Luverne, MN - Camp and Climb - Open to All Scouts
September 14-16, 2008
Note: Permission Slips must be turned in before the Trip.
Driver's Survey Form
