Nentego Lodge 20Banquet 2006 Registration
Nentego Lodge 20
Banquet 2006 Registration
Name
of Lodge member(s): ________________________________________
________________________________________
Phone:
(______)_____________________
Address: _______________________________
City, State, Zip: __________________________Chapter:
______________________
Number
of guests/Family Members Attending: _______
The
cost is $18
per person attending.
The first patch in
the 2006 Nentego Lodge Trader Series will be offered to those attending the
Banquet. Each
person attending can purchase one patch by Pre-Order for $3/patch.
*Remaining
patches will be sold at the Banquet at an increased cost.
Total number of people attending: ________
Total number of Patch Pre-orders requested: _______ at $3/patch
Total Amount Enclosed: $_______
I
understand that neither Nentego Lodge 20, its officers, members or advisers nor
the Delmarva Council, Inc. are responsible for any items lost or stolen at Lodge
functions.
Valuables should be safeguarded or left at home.
I consent to the use of photographs
or videotape, in whole or part, by the Lodge for the purpose of illustrations,
promotion, or publication.
________________________________
___/___/___
Signature of member
date
If
the member is under 18 years of age, parent or guardian must give permission for
the youth to attend and to participate in the planned activities.
Please sign below:
I,
the undersigned, hereby give___________________(youth’s first name) permission
to attend the Lodge Banquet, and to participate in any and all planned
activities. I have read and
understand the statement concerning valuables and publication.
In the event that I cannot be reached in the case of an emergency, I
hereby give the adult leaders in charge and/or attending physician permission to
provide the required medical attention.
________________________________
___/___/___
Signature of parent or guardian
date
Mail
to:
Nentego Lodge 20
Delmarva Council, Inc.
Boy Scouts of