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  $?          = $ __________

_____Adults who want a patch X $?     = $ __________

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

                    Total:                 $ __________

Registration due by January ?, 2007…A late fee of $?
will be charged for registrations after 1/?/07 and a $?
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…..

ACCIDEDNT INSURANCE  # ____________________________

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 100th Place SE
Everett, WA 98205

Office  Notes: _________________________________________________

_____________________________________________________________