2017 BLUE AND GOLD DINNER REGISTRATION
Saturday, 3/18, 6:00-8:30 pm, at the Reed Intermediate School Cafeteria

Registration deadline is 3/11/16 Please use the below form to register. Please be sure to calculate the total fee and enter it in Total Cost box. The form does not automatically calculate the total.

After submitting, please mail the check (payable to "Pack 170 w/your son(s) name in the comment) to:

Craig Marshall, Pack 170 B&G Coordinator
c/o Accuspec Inc.
600 Pepper Street
Monroe, CT 06468

All Checks should be made out “Pack 170”

If you think you may have made a mistake in the form, please do not resubmit. Please contact Craig Marshall, Blue & Gold Coordinator, at cmarshall@accuspecinc.com

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* Required
Cub Name(s) *
ex. John and Mark Smith
Your answer
Den number - Scout 1*
Den number - Scout 2
Only need if more than one Scout at event
Number of Adults *
Cost of $10 per adult
Number of Children over 3 *
Cost is $6 per child
Number of Children under 3 *
No cost
Total Cost $ *
Please add. This form does not calculate
Your answer
Parent's Name *
Your answer
Parent's Email *
Your answer
Parent's Contact number *
Your answer
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