(Please print, fill out and mail to: Daniel J. Forte, 24 Adams Lane, Wayland, MA 01778)
CHRISTIAN SERVICE BRIGADE
STOCKADE UNIT # 1953
TRINITARIAN CONGREGATIONAL CHURCH
REGISTRATION SLIP
2005-2006
NAME: _____________________________________________
ADDRESS: __________________________________________
CITY: ________________________ STATE: _____ ZIP:________
GRADE: ______________ AGE: _______ BIRTH DATE: _____________________
PHONE: _______________________
E-MAIL: __________________________________
PARENTS’ (OR GUARDIANS’) NAMES: ___________________________________
What church do you attend? ________________________________________________
How did you find out about STOCKADE? _____________________________________
Have you ever been in STOCKADE? _______If yes, what church and/or Unit # _______
What was your last level of achievement passed? ________________________________
BUILDER TRAILS ($9): $ CASH _____ CHECK _________
SENTINEL TRAILS ($9): $ DATE __________________________
SHIRT ($18): Size ____ $ ISSUED: Book _____ Shirt ________
Amt. Paid $ REGISTRATION: ($25) __________
(waived for 1st time participants)
