TAP Registration Form

Wilderness Road Council

TAP Registration Form

Only use this form for events that register through the Lexington Service Center that include event codes. To use this form, please print this form and deliver or mail to: GSWRC, 2277 Executive Drive, Lexington, KY 40505

GIRL PROGRAM REGISTRATION FORM

Leader’s Name:

Troop No.

Phone (H) (W) (C)

Email:

Address:

City: , State: Zip:

Program Event:

Program Event Date:

Cost to be charged to card listed below:

Age Level:

Event Code (if applicable):

# of girls attending # of adults attending

List any special dietary or accessibility needs:

Visa Mastercard.

Account Number: Expiration Date:

Name on Card:

ADULT TRAINING REGISTRATION FORM

Name:

Troop #:

Phone (H) (W) (C)

Email:

Address:

City: , State: Zip:

Workshop:

Workshop Date:

Cost to be charged to card listed below:

Event Code (if applicable):

List any special dietary or accessibility needs:

Visa Mastercard

Account Number: Expiration Date:

Name on Card:

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