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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