2023 NYLT Registration

2023 NYLT Registration
Please Select Which Course: *

2023 Winter 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 *

13 14 15 16 17 18 19 20
Gender *

Male Female
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? *

Yes No
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 *

Small Medium Large Extra Large XXL
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

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Subtotal $ 0.00 Tax $ 0.00 Total $ 0.00

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