Webelos 2020 | Provisional Registration Session 1 (August 2 - 5)
Use this form to register for the Provisional Unit for Webelos Summer Camp at Cherokee Scout Reservation.

For a Scout to participate in the Provisional Unit at Webelos Summer Camp, his/her parent/guardian must also attend.

The Provisional Unit is open to female and male Scouts.
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Scout Information
Scout's First Name *
Scout's Last Name *
Scout's Date of Birth *
YYYY
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MM
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DD
Scout's Gender *
Scout's Pack Number *
Scout's District Name
Scout's Council Name *
Parent/Guardian/Caretaker Information
Parent/Guardian/Caretaker 1's First Name *
Parent/Guardian/Caretaker 1's Last Name *
Parent/Guardian/Caretaker 1's Cell Number *
Parent/Guardian/Caretaker 1's Email Address *
Parent/Guardian/Caretaker 2's First Name
Parent/Guardian/Caretaker 2's Last Name
Parent/Guardian/Caretaker 2's Cell Number
Parent/Guardian/Caretaker 2's Email Address
Which Parent/Guardian will attend Webelos Summer Camp with the Scout? *
Emergency Contact Information
Please list the name of an emergency contact other than a parent or primary caretaker.
Emergency Contact's First Name *
Emergency Contact's Last Name *
Emergency Contact's Cell Number *
Special Needs Information
In this space please describe any special needs the Scout may have. They might include but are not limited to dietary, medical, physical, or cognitive needs.
Unit Leader Information
Please provide the name and email address of your Scout's unit leader. We will use this information to share your Scout's advancement report with the unit. We will email the unit leader a copy of your Scout's advancement report on the Saturday your Scout departs summer camp.
Unit Leader's First Name *
Unit Leader's Last Name *
Unit Leader's Email Address *
Payment Information
You can submit your payment two ways.

You may also submit a check made payable to Old North State Council, 1405 Westover Terrace, Greensboro, NC 27408

Or, you can pay in person at the Old North State Council Office, 1405 Westover Terrace, Greensboro.
How do you plan pay? *
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