Boy Scout Form


	Perryville Battlefield

2011 – Boy Scout Registration Form

Troop Name: ____________________________________________________________________

Troop Leader: ____________________________________________________________________

Mailing Address: __________________________________________________________________

City, State, Zip: ____________________________________________________________________

Email Address: ____________________________________________________________________

Total Participants x fee per person = $

Registration Fees are $5.00 per person. Please Make Checks Payable to: Perryville Battlefield State Historic Site

Registration deadline for all scout participants is September 15, 2011.

Print and Mail to: Perryville Battlefield Scout Registration PO Box 296 1825 Battlefield Rd. Perryville, KY 40468

List All Participants by Name - Please Print Legibly


1. _____________________________________________ 2. _____________________________________________ 3.______________________________________________ 4. _____________________________________________ 5. _____________________________________________ 6. _____________________________________________ 7. ____________________________________________

	Use additional sheets if necessary

		Office Use only: Date Received: ___/___/___ By: ________ Acknowledgment Sent ___/___/___


	8. _____________________________________________ 9. _____________________________________________ 10. ____________________________________________ 11. ____________________________________________ 12. ____________________________________________ 13. ____________________________________________ 14. _____________________________________________

		By submitting this registration form, we unconditionally agree to abide by the standards set in the rules booklet. __________________________/_________ Signature of Authorized Unit Representative and Date