Venture Crew 568 Youth Registration - Additional Information
(not on registration form)(put more on the back)

NAME: _______________________________

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Youth Venturer (optional information)
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1. Venturer's Email address:

2. Are you registered in another scout unit?

2a. What other scout unit?

3. Cell phone number:

4. Were you ever in Boy Scouts or Cub Scouts?

4a. Highest Cub/Boy Scout rank?


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Parent that is NOT on registration form (only if Venturer is under 18)
(optional information)
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1. First, Middle, Last, Suffix:

2. Address, City, State, Zip:

3. Home Phone:

4. Cell Phone:

5. Email:

6. Date of Birth: