Pack Name:

Contact Leader:

Address:

City/Town     Prov/State

Postal/Zip Code:

Phone #:

E-mail:

Estimated numbers of participants

Youth

Leaders

Parent Helpers

$25 pre-registration fee due Aug 31st

Mail to: Vanda Braunton / Camp Chief

              P.O. Box 17  RR#1

              Delaware, Ont.

              N0L 1E0