Junior Maine Guide 2011 Testing – Individual Camper Registration

Encampment Dates: July 25 – 29, 2011
Payment: If you submit your registration by email, please mail your check to MYCF, PO Box 1861, Portland, ME 04104.
Please submit this form no later than Monday, July 18, 2011.
Please note: You must submit ONE Camp Registration form for your camp and group AND an individual registration form for each participating camper.

Individual Registration Form

Camper's Full First Name:
Camper's Last Name:
Camper's Nickname:
Gender: Male Female
Age:
Date of Birth:
Name Of Camp:
Past # of years tested at JMG?
Camper's Home Address
Street:
City:
State:
Zip:
Country:
Additional Information
Assign a campsite group number for this camper:*
*Note: You may group six campers from your camp per group campsite.
I certify that the above named Junior Maine Guide candidate has:
- Treaded water for five minutes
- Demonstrated the survival float
- Can Swim 100 yards
- OR has earned a Red Cross Level IV card
Your name:
Your Title:

Payment: If you submit your registration by email, please mail your check ($115 per camper; $125 each non-MYCF member camp) separately to MYCF, PO Box 1861, Portland, ME 04104 prior to July 27. We prefer to handle money at the Portland office, but if time is short, you may bring the check to the encampment.

Please submit this form no later than Monday, July 18, 2011.