Mount Baker Council 2009 University of Scouting

Registration Form

Coming Soon! Register AND Pay online! But don't wait until next week -- register now...

 

SECTION 1: PERSONAL DATA
First Name:
Council:
Last Name:
District:
Address:
Unit Type:
Apt #::
Unit #:
City:
Type:
State:
 Zip:
 
Phone:
 SPECIAL NOTE: Youth 14 through 17 may attend University of Scouting classes but must provide a signed permission slip from his/her scoutmaster or advisor and parent, and bring it the day of the event (no exceptions). An adult must accompany these youth to the event.
E-mail:
Date:

SECTION 2: COURSE SELECTIONS

If the course is a multi-hour class, you should fill in the time slots for each portion of the class in the form below.

Class Time Offered Course Preferences (by course number)
   

1st Choice   

2nd Choice   

 3rd Choice   

Class 1
  9:00 AM
Class 2
10:00 AM
Class 3
11:00 AM
Class 4

  1:00 PM

Class 5
  2:00 PM
Class 6
  3:00 PM
Are you going for a commissioner degree?

SECTION 3: YOUTH ACTIVITY

 If child care is needed, please enter the names and ages of the children
(limited to the first 25 children registered).
Name*
Age
Gender
Rank (if Cub)

*Note – If a child requires medications or has allergies, place an asterisk next to their name.

SECTION 4: REGISTRATION AND FEES

  Item
Cost
Subtotal
 
Early Bird Registration (until Nov 12)
$ 17.00
 
Regular Registration (Nov 13 – Jan 6)
$ 22.00
 
Walk-Ins (After Jan 6)
$ 27.00
 
Youth Activity ($15 per child) pre-registrations only
$ 15.00 ea
$
 
Special Fees
  
$
 
Total Enclosed
$

 

Please bring or mail this form to the Everett Service Center or the Bellingham Service Center:
Mt. Baker Council, Everett Service Center, BSA
1715 – 100th Pl SE, #B
Everett, WA 98208		   Mt. Baker Council, Bellingham Service Center, BSA
3313 Meridian
Bellingham, WA 98225
Registration MUST be postmarked by January 6th or walk-in fee will be charged.