Gold Rush Blue Ridge Mountains Council Page 2
ADVERTISEMENT
1
2GOLD RUSH
2015 REGISTRATION FORM
CAMPOUT
(Please print clearly)
Check Session (Dates on reverse side of form)
___ Great Valley
___Mtn Empire
___ Piedmont
___ Dan River
___New River
___Patrick Henry
Description:
Cub Scout Name (s)
Pack #
Grade
Guidelines
Come and enjoy a Cub Scout Family Camping experi-
1.____________________________
______ _____
1.
Younger children should be with parents at all times.
ence. It doesn’t take a great deal of preparation, as you
2. ___________________________
______ _____
2.
No vehicles are allowed in the camping area.
3. ___________________________
______ _____
3.
No Pets or animals are allowed
Sibling (s) Attending
Age
your family.
1. ____________________________________
_____
4.
No Open Flames are allowed in tents
COST:
2. ____________________________________
_____
5.
No Motor homes or camper trailers
Early bird registration is $20/ Scout and $15 for each
Parent (s) /Guardians
6.
Activity fees are non refundable and non
1. __________________________________________
transferable.
deadline the cost increases by $5/ person. Includes all
Attending? ___yes ___no Registered Leader? ___yes ___no
7.
2.___________________________________________
Cub Scouts and registered leaders will receive the “2015
or sheath knives are permitted
Attending? ___yes ___no Registered Leader? ___yes ___no
GOLD RUSH” participant’s patch.
8.
Cub Scouts must practice family camping rules.
If a parent is not attending, Adult responsible for Scout:
Items to Bring:
9.
All participants are required to provide a completed
_________________________________________________
Tent
Sleeping Bag
Flashlight
Water
BSA medical form (parts A & B)
Scout’s Address ____________________________________
Rain Gear
Toiletries
Change of Clothes
It is not required that you stay overnight. You may come
City/State/Zip _____________________________________
BSA Medical Form (Parts A & B) for ALL participants
just for the days activities, however the fee remains the
Daytime Phone ____________________________________
same.
forms page of our website, and does NOT require a
Schedule:
doctors signature.
T-Shirt Order: $10 each (List quantities for each size)
YOUTH : Small___
Medium ___
PLEASE NOTE:
-
TO Register:
ADULT: Small___
Medium ___
Large ____
Complete the registration form (on the right) and send
XL _____
XXL ______
XXXL ___
Go to the website and click on the
it in with your payment to:
Early Registration:
GOLD RUSH
start times and directions to the event location
# of Scouts attending event
____ @$20each = $_____
Blue Ridge Mountains Council , BSA
BASIC SCHEDULE:
# of Family attending event ____ @$15each = $_____
PO BOX 7606
Roanoke, VA 24019
Late Registration fee
____ @$5.each = $_____
Saturday:
# of T-Shirts ordered
____ @10each = $______
Set up and Registration …….………….…… Morning
Total fees enclosed $________
Activity and Rotations........Start between 10:30 and noon
Payment Method:
______ Check or Money order enclosed
Dinner & evening activities ….………….……5:30—7:30
Online Registration is available on the GOLD RUSH
page of our website
______ Visa
______Discover
_____Master Card
.…………. Starts between7:30—8:00
Card # __________________________________________
Sunday:
Exp. Date _______________ Amount _________________
Breakfast .………….………….………….…… Morning
For additional Information Contact:
Name on Card : ___________________________________
Chapel….………….………….………….…… Morning
Susan McKimmy Event Registrar at
Signature ________________________________________
Break camp / Camp Closes at 10:00am
or call (540) 777-7972
Date ___________________
Acct. Code: 6CCS
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business