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BSP Activity Permit

This document is an application form for a Boy Scout to participate in a Tenderfoot Camp being held on January 22-23, 2016 at SSS Village Elementary School. It requests the scout's personal information like name, date of birth, address, parents' names, and school details. The form also requires approval signatures from the scout's parents/guardians and school authorities to certify the scout's physical fitness and qualifications to attend. Attached is a roster listing the names of participating scouts and unit leaders.

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Neil Atanacio
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© © All Rights Reserved
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460 views

BSP Activity Permit

This document is an application form for a Boy Scout to participate in a Tenderfoot Camp being held on January 22-23, 2016 at SSS Village Elementary School. It requests the scout's personal information like name, date of birth, address, parents' names, and school details. The form also requires approval signatures from the scout's parents/guardians and school authorities to certify the scout's physical fitness and qualifications to attend. Attached is a roster listing the names of participating scouts and unit leaders.

Uploaded by

Neil Atanacio
Copyright
© © All Rights Reserved
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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BOY SCOUTS OF THE PHILIPPINES

Southern Luzon Region


Metro Manila East Council
SSS Village Elementary School
APPLICATION FOR PARTICIPATION
SCOUTING EVENT: ________Tenderfoot Camp___________________________________________
DATE:
________January 22-23, 2016_______________________________________
PLACE:
________SSS Village Elementary School_____________________________
NAME:

______________________________________________________________________
Last Name
First Name
Middle Initial
DATE OF BIRTH: _________________________
PLACE OF BIRTH: _______________________
HOME ADDRESS: ______________________________________________________________________
TELEPHONE/CELLPHONE NO.: _________________________________________________________
FATHERS NAME: _________________________
MOTHERS NAME: _______________________
SCHOOL:
_________SSS VILLAGE ELEMENTARY SCHOOL_______________________
ADDRESS:
_________LILAC STREET, CONCEPCION DOS, MARIKINA CITY_______
TELEPHONE NO.: _________941-41-35___________________________________________________
SCOUTING POSITION: ________________
UNIT NO.: ____________
RANK: _______________
MEMBERSHIP CARD NO.: _________________________
EXPIRATION DATE: _______________

______________________________________
APPLICANTS SIGNATURE

______________________________
DATE

APPROVAL OF PARENTS/GUARDIANS
We hereby approved this application and certify its correctness. In consideration of the benefits to be derived,
we expressly waive our rights or claims against the Boy Scouts of the Philippines or its representatives on
account of any incident, injury, or damage to personal property that may occur beyond the control of the
organizing committee/officials provided adequate safety measures and precautions have been instituted in
connection with the participation of my son/ward in this activity.
We further agree to have my son/ward meet the health requirements which includes his/her examination by a
Medical Officer who will use the form provided for this purpose and obtain certification from school
authorities attesting to his/her academic standing.
_____________________________________________
Fathers Signature/Date

___________________________________________
Mothers Signature/Date

______________________________________________
Guardians Signature/Date
ACTION OF SCHOOL AUTHORITIES

____________________________
Date

We hereby certify that the above applicant has met all the requirements for participation in this activity as set
forth by the BSP. We have personally examined all him requirements and found him physically fit and
qualified to attend this activity. He is currently registered and on the basis of his records of satisfactory
scouting experiences and his cooperative attitude towards his fellow scouts, we hereby approved this
application.
REQUESTING APPROVAL
Neil N. Atanacio
Unit Leader
Clarita C. Cruzat
School BSP Coordinator

Freddy T. Josef
Institutional Scouting Representative
Examined by:
Physicians Name: _________________________________
License Number: __________________________________

Date: _____________________________________

BOY SCOUTS OF THE PHILIPPINES


Southern Luzon Region
Metro Manila East Council
SSS Village Elementary School

NAME OF SCOUTS

ROSTER OF PARTICIPANTS)
Tenderfoot Camp
SSS Village Elementary School
January 22-23, 2016
DATE REGISTERED

BSP ID NUMBER

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NAME OF UNIT LEADERS


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DATE REGISTERED

MEMBERSHIP ID NUMBER

SUBMITTED BY:

___________________________________
Institutional Scouting Coordinator

APPROVED:
_______________________________________
Institutional Scouting Representative

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