2023 NYLT Registration

2023 NYLT Registration
Please Select Which Course:*

2023 Summer Course
Participants Name*

First Name Last Name
Nickname (if desired)
Participants E-mail
Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Participants Phone Number

Area Code Phone Number
Age at the beginning of the course*

1314151617181920
Gender*

MaleFemale
School Grade*
Rank (Boy Scout) ; Award (Venturer)*
Unit Position/Leadership Position In Scouting *
Years in Scouting
Unit Type*
Unit Number*
District
Council
May we send information by e-mail instead of regular mail?*

YesNo
Parent Name/Guardian*

First Name Last Name
Parent/Guardian Phone Number*

Area Code Phone Number
Parent(s)/Guardians E-mail*
If someone other than the above person will serve as an emergency contact please list that info here
Note: Parent(s) e-mail will be the primary e-mail for providing information about the NYLT course. If the Scout has a personal e-mail account, course information may be send to that e-mail address as well. In every case, parents will receive the same e-mail as the Scout.
Adult T-shirt size*

SmallMediumLargeExtra LargeXXL
Special Dietary Restrictions (If none, enter "none")*
How did you learn about NYLT?
Please provide more details on how you learned about NYLT
Explain briefly why you want to attend NYLT and what you expect to gain*
On my honor as a Scout, I will faithfully live and act the Scout Oath and Law while I attend NYLT. I further promise to represent my Unit with honor and promise to pass along my new skills and knowledge to the other members of my Unit when I return from NYLT. I have provided this information to the best of my ability. I agree to comply with the NYLT Uniforming Policy and Mandatory Personal Equipment List that will be provided by my Course Director. I understand that I should arrive at camp on time and may not leave camp during the week. I understand that I can be sent home if I do not follow these policies.
*

I agree with the NYLT Policy stated above
Unit Leader (Scoutmaster/Venturing Advisor/Skipper) Information
Name*

First Name Last Name
E-mail*
Phone Number

Area Code Phone Number

Deposit/payment*

NYLT Deposit (681)$50.00

NYLT Full Fee (681)$250.00

NYLT Balance$200.00

NYLT Half Payment$125.00

Enter coupon

Subtotal $0.00Tax $0.00Total $0.00

Credit Card

Should be Empty: