Advisor: First Name *
Last Name *
Phone *

Address *
City *
State *
Zip *

E-mail Address *
Fax

High School or Group Name *
County *

Address *
City *
State *
Zip *

Please select the number of Team Members: *
How many Advisors are in your group?

How many Students are in your group?
Is your group camping on Friday night? *

Include an alternate student? *
$50 fee is required for Friday Night Meals