RESIDENT CAMP REGISTRATION FORM

This form and $35 per participant are due to Jimmy Flythe on or before April 22, 2007 to reserve your spaces.  Please make checks payable to Pack 909.

Scout name:______________________________________________________________

Scout rank: ______________________________________________________________ 

Adult camper name: _______________________________________________________

Phone Number: __________________________

Email Address: __________________________

Do you plan to use your own tent? ___________________________________________

You may bring your own tent or use the ones that Raven Knob will have already pitched. 

Is there any physical impairment that needs to be considered?                yes        or         no  

If yes, please explain:  _____________________________________________________