2014 Great Neusiok District Pinewood Derby Race

Registration Form
When: Saturday, March 29, 2014
(Registration begins at 7:45 am) (Class A Uniform)
(Registration ends at 8:30 am. Please be on time)
Deadline to register is Tuesday, March 25th, 2013

Where: Smithfield First Baptist Church

202 South 4th St., Smithfield, NC 27577

Cost: $7.00 per scout (Fee must be paid prior to race)

Name of registering leader: _________________________________
Contact phone & email: _____________________________________
Pack# __________
1st Place: _______________________________________
2nd Place: _______________________________________
3rd Place: _______________________________________
Possible Alt: _____________________________________
Submit this registration form with payment, to the Council Office:
316 East Walnut St., Goldsboro, NC 27530
Email Rodney Taylor at rstaylor27577@outlook.com pictures of the top 4 cars with Scouts and
their names. Please contact ryan.roberts@scouting.org with any questions or if you would like
to help at the event.