REGISTRATION FORM  
 
For More information contact: Jeff Clarke, webdesign@kc4wd.co.nz, 027 515 1993

Name *
Address *
Phones *
Email *
Unit Name *
Please don't put Ventures, Scouts or Unit. eg. Put Hillcrest, not Hillcrest Venturers.
Venturer\Adult\Leader * Venturer
Adult
Leader
Emergency Phone *
I will Mountain Bike * Yes No                    (can do both MB & Tramp)
I will Mountain Tramp * Yes No
Medical Conditions
(Leave blank if none.)

Other Comments (including special food requirements)
        

Security Question.