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Registration Form


All fields with ** are required to be filled in.
 

Please complete this form and return it to our Registrar as soon as possible.  The deadline for registration is:  April 15, 2001.
 

**Group/Unit: 
       City: 

**Contact Person: 

**Mailing Address: 

**Phone Number: 
  FAX #: 

E-Mail: 

**Special Requirements: 

** # Participants 
x $20 =

** # Adults 
x $20 = 

 **Total fees remitted    $
(Cheque or money order Canadian Funds -  Payable to "Scouts Canada - Porcupine District")
**Expected time of arrival(date & time): 

**Expected time of departure:(date & time)

**Number of vehicles expected (please specify cars/vans or busses): 


Please send Registration Form and cheque/money order to:

  Gold Rush Rendezvous 2001 Registration
  654 Park Avenue
  Timmins, ON  P4N 3X6

NOTE: We make no guarantee camping sites will be available unless we receive your registration form by the deadline date.  Campsites are limited at the Park–please register early.
 
 



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