Form

Summer Ordeal

Quelqueshoe Lodge
First Name:
Last Name:
E-mail:*
Phone Number:
Address:
City:
State:
Zip:
Unit #:
Are you a Youth or Adult?

Youth Adult
Select One:
Gender:

Male Female
Special Needs:
Please bring or mail your payment to the scout office before August 18th. If you would like to make a Credit Card payment you can call the Scout Office with that information. The mailing address for the scout office is:
Quelqueshoe Lodge - Spring Ordeal, 304 Dr. Michael DeBakey Drive, Lake Charles, LA 70601
Please bring your medical form to the Ordeal.
Should be Empty:

Summer Ordeal