Register to reserve your space at theMid-America Union PBE Club Information Conference Name Central States Dakota Iowa-Missouri Kansas-Nebraska Minnesota Rocky Mountain Church Name Club Name Club Director Information Club Director Name Club Director Email Club Director Cell Phone PBE Head Coach Information Head Coach Name Head Coach Email Head Coach Cell Phone Required Forms Will you bring a signed Statement of Integrity Form for your clubs' PBE team(s)? Yes No Will you bring a signed Media Release Form for each pathfinder participating in PBE (including Alternates & Runners)? Yes No Team Information Many teams have a unique name that is different than the club name. It offers each team a chance to come together on something special and meaningful and be unique. Team 1 Name Team 1 - Number of Pathfinders on Team 1 2 3 4 5 6 7 Team 1 - I verify that we will supply an Adult Monitor with this team (required). Yes No Team 1 - I verify that the Adult Monitor we provide will attend and be on time (important) to the 2:15 PM Monitors’ Meeting. Yes No Will Team 1 have it's own runner? Yes No Team 2 Name Team 2 - Number of Pathfinders on Team 1 2 3 4 5 6 7 Team 2 - I verify that we will supply an Adult Monitor with this team (required). Yes No Team 2 - I verify that the Adult Monitor we provide will attend and be on time (important) to the 2:15 PM Monitors’ Meeting. Yes No Will Team 2 have it's own runner? Yes No Team 3 Name Team 3 - Number of Pathfinders on Team 1 2 3 4 5 6 7 Team 3 - I verify that we will supply an Adult Monitor with this team (required). Yes No Team 3 - I verify that the Adult Monitor we provide will attend and be on time (important) to the 2:15 PM Monitors’ Meeting. Yes No Will Team 3 have it's own runner? Yes No Submit
