PACK 124 REGISTRATION FORM - SCOUT YEAR 2005-2006
FOR RETURNING MEMBERS ONLY

Please fill out one form for each Cub Scout that is returning.

Scout's Name: _____________________________________________ Grade: _______

Address: ________________________________________________________________

Phone: ______________________________ Birth Date: ____ / ____ / ________

Parents or Guardians Names: ________________________________________________

Address (if different): ______________________________________________________

Allergies / Medications / Limitations: __________________________________________

By registering my child for Andover Cub Scouts Pack 124, I understand that it is required that I take an active role in assisting my den leader. This includes attending den and pack meetings along with my child, donating time and resources as needed, and even leading a den activity if requested.

Fees:
Registration and Pack Activity Fee for entire year: $ 45.00
For each additional Cub Scout in family: $ 40.00

Make checks payable to: PACK 124, BSA

** By October 1^st 2005, please return form and check to your den leader or mail to: **

Cub Scout Pack 124
c/o Keith Boushee, Cubmaster
148 Bear Swamp Rd
Andover, CT   06232-1546
(860) 742-9620

Questions? Contact Keith Boushee (cubmaster@pack124.org), Cubmaster, or
                               Tim Fogarty (asstcubmaster@pack124.org), Assistant Cubmaster

Please list any talents / skills / hobbies / occupation skills that you would be willing to share with a den:

Dad: _________________________________________________________________

Mom: ________________________________________________________________

Brother / Sister: ________________________________________________________