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Water World 2011

July 28 - July 31

Tims Ford Lake

Registration

REGISTER NOW!!!!!!!!!! DO NOT WAIT!!!!!!!!!!!!!!!

Please complete the following information then click on the SUBMIT button at the bottom of the page:

 

Name of person completing this registration: 

Primary e-mail address:       Alternate e-mail: 

Primary phone number:     Secondary phone: 

 

Is your family staying on the island with the Troop? 

 

Will you be driving to Waterworld?

If you are driving, please complete the following in order for you to be placed on the limited insurance policy and covers you while transporting scouts.

 

   Name of Vehicle Owner:

   Make AND Model of Vehicle: 

   # of passengers traveling with you: 

   Driver's license number of person driving: 

   Insurance liability limits:

             Bodily Injury: 

      Limit per accident: 

       Property damage: 

 

If the person completing this form is attending, please list yourself as Attendee #1 below.

Who is coming?  Please list everyone attending with your family.

 

Attendee #1

 

1. Name:     (Please include first & last name.)

     Age:        (Age only needed for individuals under the age of 18)

     Scout?     If yes, normal patrol assignment:  

     If this person is a Scout, would they like to be considered to serve as a Patrol Leader while camping? 

     Other Patrol Leader Comments: 

 

     If this person is an adult, are you BSA Safety Afloat Certified?    If yes, expiration date:

     If this person is an adult, are you CPR?    If yes, expiration date:

 

Please note - your arrival & departure times must coincide with one of the scheduled ferry times

 

     When will this person be arriving?       

     When will this person be leaving?   

 

Attendee #2

 

2. Name:     (Please include first & last name.)

     Age:        (Age only needed for individuals under the age of 18)

     Scout?     If yes, normal patrol assignment:   

     If this person is a Scout, would they like to be considered to serve as a Patrol Leader while camping? 

     Other Patrol Leader Comments: 

 

     If this person is an adult, are you BSA Safety Afloat Certified?    If yes, expiration date:

     If this person is an adult, are you CPR?    If yes, expiration date:

 

Please note - your arrival & departure times must coincide with one of the scheduled ferry times

 

     When will this person be arriving?    

     When will this person be leaving?   

 

Attendee #3

 

3.  Name:    (Please include first & last name.)

     Age:        (Age only needed for individuals under the age of 18)

     Scout?     If yes, normal patrol assignment:   

     If this person is a Scout, would they like to be considered to serve as a Patrol Leader while camping? 

     Other Patrol Leader Comments: 

 

     If this person is an adult, are you BSA Safety Afloat Certified?    If yes, expiration date:

     If this person is an adult, are you CPR?    If yes, expiration date:

 

Please note - your arrival & departure times must coincide with one of the scheduled ferry times

 

     When will this person be arriving?    

     When will this person be leaving?   

 

Attendee #4

 

4.  Name:    (Please include first & last name.)

     Age:        (Age only needed for individuals under the age of 18)

      Scout?     If yes, normal patrol assignment:   

 

     If this person is an adult, are you BSA Safety Afloat Certified?    If yes, expiration date:

     If this person is an adult, are you CPR?    If yes, expiration date:

 

Please note - your arrival & departure times must coincide with one of the scheduled ferry times

 

     When will this person be arriving?    

     When will this person be leaving?   

 

Attendee #5

 

5.  Name:    (Please include first & last name.)

     Age:        (Age only needed for individuals under the age of 18)

 

     If this person is an adult, are you BSA Safety Afloat Certified?    If yes, expiration date:

     If this person is an adult, are you CPR?    If yes, expiration date:

 

Please note - your arrival & departure times must coincide with one of the scheduled ferry times

 

     When will this person be arriving?    

     When will this person be leaving?   

 

Attendee #6

 

6.  Name:    (Please include first & last name.)

     Age:        (Age only needed for individuals under the age of 18)

 

     If this person is an adult, are you BSA Safety Afloat Certified?    If yes, expiration date:

     If this person is an adult, are you CPR?    If yes, expiration date:

 

Please note - your arrival & departure times must coincide with one of the scheduled ferry times

 

     When will this person be arriving?    

     When will this person be leaving?   

 

Attendee #7

 

7.  Name:    (Please include first & last name.)

     Age:        (Age only needed for individuals under the age of 18)

 

     If this person is an adult, are you BSA Safety Afloat Certified?    If yes, expiration date:

     If this person is an adult, are you CPR?    If yes, expiration date:

 

Please note - your arrival & departure times must coincide with one of the scheduled ferry times

 

     When will this person be arriving?    

     When will this person be leaving?   

 

 

Another other comments you'd like to make:

 

Please review all of your entries above proceeding.  Once you've confirmed that everything is correct,

click on the "Submit" button to submit your registration.  An e-mail containing the information will

automatically be sent to Chrissie Coombs.  Should you have any further registration questions you can contact

Chrissie at:  chrissiecoombs@comcast.net

 

    

 

 

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This site was last updated 05/13/11

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