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Scout and Special Group Program Registration and Payment Form
Please use this form to register and pay for your program.
Contact Information
Leader's Name
*
First Name
Last Name
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Email
*
Verify Email
*
Phone
*
Name of Troop/Group
Age of Participant
5-7
8-12
13-18
over 18
Number of Participants
List any special needs or considerations.
Requested Date
*
(mm/dd/yyyy)
Time of Program
*
Programs
Please choose the program that you are interested in.
2 hour Horse Care Program
2 hour Horses Helping Humans
2 hour Cowboy Logic STEM
2 hour Lead Ropes Leadership
2 hour Christian Focus
2 hour Farm Scavenger Hunt
Badges
Leader's Training/Certification
Overnight camping/program
other
If other, please describe.
Amount
$50
-
Deposit
$
Other information
