Counselor Registration by 7xS3ef

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									                                                         SCOUT ADVANCEMENT WEEKEND
                                                         Counselor / Instructor Registration
 Please print legibly

              Name

   Class / Course        Check program area you are teaching. Please plan a full program, do not send scouts out early

    Program Area:               Webelos           Venturing                Merit Badge                                     Adult

             Class you are teaching                         4 hour class              8 hour class                             # Adult Sessions         1 hour or      2 hour

 Webelos and Merit Badge Counselors: What is the maximum number of youth you prefer in your session?

           Address

                 City                                                                                                           ST                ZIP

        Day Phone        (         )        -                              Home Phone        (         )      -

              E-mail                                                        Cell Phone       (         )      -
 Don’t registered with your unit to attend SAW
             (check one and show unit #)                        Pack                  Troop                   Crew

 Are you registered as a merit badge counselor with the Gulf Stream Council?                      Yes                     No                     Don’t know

 When will you arrive?                     Friday Evening                   Saturday Morning

 Will you be camping?                      No                               Friday Night                      Saturday Night

 Do you need a dormitory room (subject to availability)?                    Yes                   No

 Will you need transportation for your supplies or materials from the parking lot to your learning area?                       Yes                   No

 Please make every effort to obtain donations to support your program area.

 List any special facility needs such as tables and chairs, access to electricity, etc.




                                                                             Please complete all information and return form to kelsey.cupples@scouting.org
                                                                                                   or send to: Gulf Stream Council, BSA
              GULF STREAM COUNCIL                                                 Attention SAW, 8335 N Military Trail, Palm Beach Gardens, FL 33410

 To order a t-shirt or additional patches, include check payable to Gulf Stream Council.

     T-Shirt $6.00 each – Qty              (Check one)         S       M      L       XL         XXL          XXXL              Extra Patches: $3.00 each - Qty

    Camp for the weekend $10.00

    Day only free                                                                                                              Total enclosed $__            ___________
 Talent Release - Registration for this activity includes permission for Gulf Stream Council to use voice and/or photographs of participants in news coverage or similar projects approved
 by the Boy Scouts of America. Refund requests must be made in writing to the Council Service Center the day of the event.


 Credit Card #                                                         .                             Exp.:    /   .


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