EmailMeForm
Bob Berger First Aid Meet 2014
Please fill out the information below and click submit to send the registration to Troop 105.
Troop/Pack #
*
Please enter the troop or pack number in this field, this field is required to submit the form.
Contact Person
*
Please enter the troop or pack contact person in this field, this field is required to submit the form.
Contact Email
*
Please enter the troop or pack contact persons email address in this field, this field is required to submit the form. Confirm the email address by re-typing it in the field below.
Confirm
Contact Phone Number
*
###
-
###
-
####
Please enter the troop or pack contact person's phone number in this field, this field is required to submit the form.
Number of Scouts @ $5 each
*
This will be the number of scouts, not the number of patrols, this field is required to submit the form.
Number of additional patches @ $2 each
Number of adults taking CPR for the 1st time
The cost of this will be determined by and paid to the instructor.
Number of adults re-certifying in CPR
The cost of this will be determined by and paid to the instructor.
