Event Location with Address

Bring your Troop patrols out to compete with others from around the district! Campout over the weekend and have fun watching Scouts compete in skill challenges on Saturday.

Event Times: Friday, January 29: 4:00 pm- 8:00 pm Saturday, January 30: 8am-4:30pm Sunday, Jan 31: 9:00 am Check out

Event Location With Address: Wildcat Hollow 1940 Stuart Smotherman Rd. Russellville, KY 42276 Contact Information: Scott Irvine Drew Hopkins 270-498-8264 270-875-7457 [email protected] [email protected]

Please fill out the attached registration form Send to the Sam Swope Scout Center Attn: 2016 Tecumseh Klondike Derby 12001 Sycamore Station Place Louisville, Kentucky 40299 Fax: (502) 361-7899

2016 Tecumseh Klondike Derby Jan 29-31, 2016

Youth Name(s) (First and Last) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Adult Name(s) (First and Last) 1 2 3 4 5 6 7 8 Bring your troop patrols out to compete with others from around the district! Campout over the weekend and have fun watching scouts compete in skill challenges on Saturday.

COST: $15.00 per Youth $10.00 per Adult $3.00 per extra patch

TROOP #:______DISTRICT: ______UNIT LEADER NAME: ______

MAILING ADDRESS: ______

CITY: ______STATE: ______ZIP: ______

PHONE: ______

EMAIL: ______

TOTAL YOUTH: ______TOTAL ADULTS: ______METHOD OF PAYMENT: ______(Credit Card, Check, Cash)