Southwestern Rendezvous 2010
Pre-Registration Form

DIRECTIONS:

1) Fill in the informatiion below.
2) Select SAVE.
3) Print this form and mail it with a check (payable to “Rendezvous”) for $25.00 ($50 after October 22nd)
NOTE: Please complete a pre registration for each RENDEZVOUS team that you will have. Use the same ship number but assign a unique name.

Ship #:   Ship Name:
Council Name: 
Skippers Name:  First  Last
Address 
Address 
City:    State:    Zip: 
Phone Number: 
E-mail address: 

Boatswains First Name:  Last Name: 
Boatswains Email address:   

Indicate the number of participants (estimate please - we will not hold you to this count, but it will help us plan):

Number of Youth, Male:       Number of Adult, Male:
Number of Youth, Female:       Number of Adult, Female:

Special Needs:
Include gender, if an adult or youth member, and details:
Special Needs 1: 
Special Needs 2: 
Special Needs 3: 

When do you anticipate arrival: