May Ordeal / Brotherhood Registration Form
Name:		Unit #:
Address:
City State & Zip:
Chapter:		Home Phone:
Work Phone:	Email:
Circle One:	Youth	Adult
Please just check one box! q Check here if you are an Ordeal Candidate ($35.00) q Check here if you are a member ($15.00) q I wish to serve as an Elangomat for the weekend! ($15.00) q Check here if you wish to convert to Brotherhood ($30.00) q Check here if you wish to convert to Brotherhood but can only attend ceremony($15.00)
Required Parental Permission Form
I hereby authorize my above named Scout to attend and give full permission for his participation in this Weekend. In the event of illness or accident in the course of such activity, I request that measures be instituted without delay as medical personnel dictates.
Print Parents Name		Phone:
Date:_____________________	_________________________ Parent/Guardian signature If Scout is under 18 years old	__________________________ Scout's Signature

If you are an Ordeal Candidate, the cost for the weekend is $35.00. Cost for members is $15.00 which includes all meals. Note that Brotherhood Conversion is $30.00. Deadline to mail your form in is April 27, 2007. After that date, please add $5.00 for the late fee. Make Checks payable to:

Old North State Council, PO Box 29046, Greensboro NC 27429-9046

Note: A Medical Form is required! Click here for the form... Or you can make a copy of the medical used for Summer Camp and mail.