TLUSA NE EquipYouth Camp Pinnacle Registration 10/7-9/2016
621 Pinnacle Road, Voorheesville NY 12186 (518)872-9100
Will your parent also be attending Equip or YouthEquip?
Registration
Christian Religious Faith
Parent Contact Information
First & Last Name
Your answer
Home Street Address
Your answer
City
Your answer
State Abbreviation
Your answer
Zip Code
Your answer
eMail address
Your answer
Phone
Your answer
EquipYouth Staff / Participant Information
Adult ONLY TLUSA Membership ID
ID on your Lanyard ID or NA if none
Your answer
Youth ONLY - Your age on Oct 7th
Your answer
Troop #
TLUSA Troop Number (PA-0000)
Your answer
Troop Leadership Position
Your answer
Last name
Your answer
Nickname
Your answer
First and Middle name(s)
Your answer
Comments: food allergies or any other special needs
Your answer
First Aid certifications?
Your answer
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