Pack 735 Information Form

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* 1. At what email address would you like to be contacted?

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* 2. Scout(s) Name

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* 3. Date of Birth

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* 4. School

Joshua Eaton

Killiam

Other (please specify)

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* 5. Grade

K - Lion

1 - Tiger

2 - Wolf

3 - Bear

4 - Webelos

5 - Webelos 2

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* 6. Parent/Guardian A

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* 7. Adult A Phone

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* 8. Parent/Guardian B

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* 9. Adult B Phone

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* 10. Adult B Email