Unit Registration Form
(Please use a separate form for each clinic)
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Unit   Number Charter   Organization: _____________________________________
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Unit   Contact: Telephone: ________________________
List the name of each Scout attending the clinic and the merit badge he will take:
Scout's Name Merit Badge Scout's Name Merit Badge
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__________________________     ________________     __________________________     ________________
__________________________     ________________     __________________________     ________________
__________________________     ________________     __________________________     ________________
__________________________     ________________     __________________________     ________________
Registration fees (you only need to complete one line, based on when you register):
Count Fee Subtotal
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Number   of Scouts registered by mail by the   1st $2
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Number   of Scouts registered at Roundtable $3
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Number   of walk-in Scouts $5
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(Note: No walk-ins for Woodworking   or Electricity)
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Number   of Scouts registered for Woodworking   or Electricity $5
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Account Number (please write on check):1.6801.291.20         TOTAL FEE
Special Rules for
Woodworking and Electricity:
Due to the nature of these clinics, any Scout who wants to attend these clinics must pre-register.  The cost for each clinic is $5.  One adult must accompany every two Scouts.  Each class is limited to 20 Scouts