Pack 3455 Cub Scouts Registration
Once the dens are formed up the parents in the den, along with the den leader, will determine the time, day and location of the den meetings. At the present time, the dens have access to the American Club on a weekly basis on Saturday, but the dens may decide to meet at any other time, day, and place they choose.
Scout Information
First Name *
(no initials or nicknames)
Your answer
Middle Name
Your answer
Last Name *
Your answer
Suffix
Your answer
Address *
Your answer
City *
Your answer
State
(leave blank if outside the US)
Your answer
Zip code
(leave blank if outside the US)
Your answer
School *
Your answer
Grade *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Parent/Guardian Infomation
Your Relationship *
Your First Name *
(no initials or nicknames)
Your answer
Your Middle Name
Your answer
Your Last Name *
Your answer
Your Suffix
Your answer
Your Address *
Your answer
Your City *
Your answer
Your State
(leave blank if outside the US)
Your answer
Your Zip code
(leave blank if outside the US)
Your answer
Your Cellphone *
Your answer
Your Date of Birth *
MM
/
DD
/
YYYY
Your Previous Scouting Experience *
Your answer
Your Email address *
Your answer
Confirmation
Confirmation and Authorization *
Required
Parent/Guardian's Full Name *
Your answer
Today's Date *
MM
/
DD
/
YYYY
Submit
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