LaSalle NYLT 2010 Application Form

July 11 – 17, 2010

Camp ToPeNeBee

 

Name _________________________________       Home Phone _________________

Address _______________________________        Date of Birth ____ / _____ / _____

City _______________________________State _____ ZIP ______ e-mail _________

 

Troop _____________ Rank _________ Leadership position ____________________

 

I want to attend LaSalle NYLT 2010. In signing this form I agree:

1. I am or will be at least 13 years old by the first day of LaSalle NYLT

2010.

2. I presently hold or will hold a leadership position in my troop.

3. I understand acceptance to this course is on a “first come, first served”

basis.

4. I have ___ (have not __) completed Troop TLT leadership training

course and have a Trained patch on my uniform.

 

Scout signature ______________________________________

T-shirt size: (circle)  S  M  L  XL  XXL  XXX

 

As the Parent of this Scout:

1. I give my permission for and support this training.

2. I understand the $50 Interest Fee is non-refundable.

3. I understand the total cost is $210 (including Interest Fee).

After May 15, 2010, cost is $240.

4. Complete and return this form to LaSalle Council Office by May 15,

2010.

 

Parent signature __________________________________________

 

As the Scoutmaster for this Scout:

 

1. This Scout fulfills the requirements for entry into this course.

2. This Scout will be at least 13 years old, First Class rank, and is expected

to be in a leadership position in my troop.

3. I give permission for LaSalle NYLT 2010 to train this Scout.

 

SM Signature ________________________Name ________________

 

Address __________________ City __________ State ___ZIP ______

 

Phone __________________________ e-mail_____________________________