PRE-REGISTRATION

for Redwood District Klondike Derby, February 7-8 2004,
Cisco Grove Campground

more NEWS at: http://home.att.net/~hitchings/troop42/klon2004.htm

Please deliver or mail this form, and a check for $50 payable to B.S.A., to the BSA Office at:

Mail ONLY (revised 1211/03)
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BSA (Klondike Deposit)
P.O. Box 5005
San Mateo
CA 94402

PROVIDE THE ALL FOLLOWING INFORMATION BELOW:

District: ______________        Troop or Crew No. __________________

Preliminary Estimate of number of Adults and Scouts:______________

Name of your Primary Contact for this event _______________

Best phone number for this person:______________________

Best fax number for this person:__________________________
(if known, else leave blank)

Best email for this person:______________________________
(if known, else leave blank)

Name of Snow Camping-trained person:____________________
(minimum one required, must be on the trip)

Dont forget the check for $50 ! ______________
Your cancelled check is your receipt

All questions to Tony Hitchings, Klondike Coordinator, Bus 650-689-8328, evgs/wknds 650-578-0446

BSA Office Staff:

1: Please date-stamp and hold this form for copying by Tony Hitchings, and deposit the checks to the District account.
2: Please indicate that a check was included by circling Y / N <<<here

Tony Hitchings will fax a copy of this form to the Unit's contact person unless a different fax number is provided