NINTH ANNUAL

KLAHAYA DISTRICT KLONDIKE DERBY

FEBRUARY 10, 2007

EXIT 76, Ensign Ranch, Cle Elum, WA

REGISTRATION FORM PACK/TROOP # ______District ____________

Leader in charge: ______________________________________________

Phone: ______________________Email ___________________________

We will have ________Webelos Dens

We will have ________Scout Patrols

Enclosed are our fees for the Klondike:

          _____Scouts(Webelos)    X  $9.00   =       $ __________

          _____Adults                   X $4.00    =               $ __________

_____Late Fee of $10 or $20 ?          =      $ __________

                                                Total:                 $ __________

Registration due by January 29,2007…A late fee of $10.00 will be charged for registrations after 1/29/06 and a $20 late fee will be charged if unit registers the day of the event. (Late fees are per pack or troop)

Refunds will be made for up to 4 Scouts or Adults if notified the day of the Derby.

ATTACH COPY OF TOUR PERMIT TO THIS FORM…..

ACCIDENT INSURANCE  # ____________________________

If you want to stay overnight in a Cabin you must contact Ensign Ranch directly at

Ensignranch2003@yahoo.com  OR 509-656-2344

Make checks payable to Mt Baker Council, BSA

(Bring your receipt to the Derby..Patches will be distributed at the Derby)

IF WE RUN SHORT OF PATCHES WE CANNOT REORDER, SO THOSE WHO PAY FIRST WILL GET THEIR PATCHES FIRST

Mail or Deliver to:   Klondike Pete

                               Mt Baker Council, BSA

                               1715 100^th Place SE