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Registration Form


Please complete this form and return it to our Registrar as soon as possible.  The deadline for registration is:  April 15, 2001.
**Online registration is under construction.  Please check back.  This form can be printed.

Group/Unit:  __________________________________       City:  ____________________________

Contact Person:  __________________________________________________________________

Mailing Address:  __________________________________________________________________


Phone Number:  ______________________  FAX #:  _____________________________________

E-Mail:  ______________________________________________________________ (print clearly)

Special Requirements:  ____________________________________________________________

   # Participants  ______________ x $15 = _______________________

   # Adults ____________________ x $15 = _______________________

 Total fees remitted    $__________________ (Cheque or money order Canadian Funds
                                                                         Payable to "Scouts Canada - Porcupine District")

Expected time of arrival:  _________________    Expected time of departure:  __________________
    (date & time)        (date & time)

Number of vehicles expected:  ____________ cars/ vans  ___________ busses

Please send Registration Form and cheque/money order to:

Gold Rush Rendezvous 2001 Registration
Box 3
Matheson, ON  P0K 1N0


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.