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Registration Form

Please complete this form and click "submit". 
The deadline for registration is:  April 15, 2001


Contact Person

Mailing Address

Phone Number


E-Mail Address

Special Requirements

# Participants

x $20

# Adults

$ 20

Total Fees to be 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 cheque or money order to:
Gold Rush CJ-PRE-JAM Registration
Box 3
Matheson, ON P0K 1N0

NOTE:  Campsites are not confirmed until payment has been received.  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.