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Pack 4 Registration
Please use this form to register or renew your son's membership in Pack 4 for the 2016-2017 year. Please complete one form for each Cub Scout in your family.
I am registering a
Cub Scout's First Name
Your answer
Cub Scout's Last Name
Your answer
What grade will your Cub Scout be in (as of 9/16)?
Required
School:
Cub Scout's Mailing Address
Your answer
Cub Scout's Phone Number
xxx-xxx-xxxx
Your answer
Parent/Guardian 1 Name
Your answer
Parent/Guardian 1 Mailing Address
Required
Parent/Guardian 1 Cell Phone Number
xxx-xxx-xxxx
Your answer
Parent/Guardian 2 Name
Your answer
Parent/Guardian 2 Mailing Address
Parent/Guardian 2 Cell Phone Number
xxx-xxx-xxxx
Your answer
Primary Email Address for Pack Communications
Your answer
Secondary Email Address for Pack Communications
Your answer
I give permission to have photos taken of my son for use in Pack communications, including the Pack website:
Do you have special skills or talents you'd like to share with the Pack?
Please let us know how you can help Pack 4.
Your answer
Please share anything you think Cub Scout leaders should know about your Cub Scout such as physical limitations, prohibited activities, medical conditions, allergies, developmental concerns, etc.:
Your answer
Annual membership in Pack 4 is $70. I will be paying by
Send checks payable to "Pack 4 Needham" to Andrea Carter, 18 Colonial Road, Needham, MA 02492
No Scout will be denied membership in Pack 4 due to financial circumstances. Scholarships are available for all Pack fees by contacting Andrea Carter (confidentially) at 781-559-3420 or committee.chair.pack4@gmail.com.
Thank you for your membership in Pack 4. We look forward to another great year!
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