14th Annual Crew 9001 Venturing BSA VENTURER NIGHT LOCK-IN When: December 7-8, 2013 Time: 10:00 p.m. - 6:30 a.m. Where: YMCA – 218 E Lawrence St., Appleton, WI Cost: $25 before November 23, 2013 $30 if registration & payment are received after November 24, 2013
Walk-ins: $35 at the door but cannot be guaranteed a T-Shirt One adult gets in free for every 8 pre-registered, pre-paid Youth Directions: The YMCA is located at 218 E. Lawrence St. just off of E. College Ave. There is a parking ramp next to the YMCA for overnight parking. The doors open at 10:00 p.m. and will close at 11:00 p.m. During the night the emergency contact number is (920) 954-7629 Do you like to play games, win prizes, and meet new People? Well if you do, the 2013 Bear Paw Staff & Venturing Crew Lock-in is a perfect event for you! Crew 9001 welcomes all Venturers, Boy & Girl Scouts, Explorers, & Youth Groups to participate. Even if you are not in a registered group but are interested, you may still attend. Any youth 13-20 years of age is welcome to attend but must have two adult leaders attend. This is a great opportunity to meet other groups like yours and find out what they like to do. If you are not in a group, this is the perfect opportunity to get involved! Altogether, it will be an ideal night to meet people, experience new things & to simply HAVE FUN!
You will receive:
Activities: ¤ ¤ ¤ ¤ ¤ ¤ ¤ ¤
Open Pool (10:00 p.m. – 1 a.m.) Inflatable Climbing Tower Open Gym Volleyball Courts Basketball Courts Movies Playing All Night Door Prizes And Many More!!
“Venture Night” T-Shirt Pizza & Soda throughout the night An entry to great door prizes
What to bring: * Sleeping Gear (if desired) * Swimming Suit * Towel * Clothing To Fit The Nights Activities * Money For Trading Post & Activities * A Good Attitude * Bring A Friend!!
* Separate Youth & Adult sleeping accommodations will be available.*
Contact LuAnn Matuszak, Lock-in Crew Advisor, should you have any questions or concerns: (920) 497-1610 or
[email protected]
Please mail the completed form below along with payment, cash or check payable to: Crew 9001 LuAnn Matuszak 1101 Dousman St. Green Bay, WI 54303
_________________________________Detach Here___________________________________ Every participant MUST fill out HIS or HER OWN REGISTRATION, including ALL Adults & Crew 9001 Members! Please Print Clearly First Name: ________________________________ Last Name: __________________________________ Date of Birth (MM/DD/YYYY): _______/_______/____________ Unit Number: ______________________ Address: ______________________________________________________________________________ City: ____________________________________ State: ___________ Zip Code: ____________________ Home Phone #: (__________) _______________-___________________ Email: ________________________________________________________________________________
Circle T-Shirt Size: S M L XL XXL
3X $3.00 More
Approval of Parents or Guardians (For ventures and Guests under 18 years of age, participation in a Venturing Activity) In consideration of the benefits to be derived from participation in this Crew trip or its activity, any and all claims against the Boy Scouts of American or its local Councils. Venturing Crew, and chartered organization, or against the officers, employees, agents, or other representatives of any of them, or any other persons working under direction or engaged in the conduct of their affairs, arising out of any accidents, illness, injury, damage, or other loss or harm to/or incurred or suffered by the applicant named above or his or her property, in connection with or incidental to the Crew trip or activity, including preliminary training & travel, are hereby expressly waived by the applicant and applicant’s family or guardian. In the event of an illness or injury occurring to my son or daughter while involved in the Crew trip or activity, I consent to x-ray examination, anesthesia, and/or medical or surgical diagnostic procedures or treatment considered necessary in the best judgment of the attending physician & performed by or under the supervision of the number of the medical staff of the hospital furnishing medical services. It is understood that in the event serious illness or injury, reasonable efforts to reach me will be attempted. Insurance Company: _____________________________________Policy #: ________________________________ Emergency Contact Name: ___________________________________________________________ Emergency Contact Phone #: (___________) ______________-_________________ Parents/Guardian Signature: __________________________________________________ Date: ______________
