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Boy Scout Information Sheet

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					2005 CAMP THUNDER
BOY SCOUT INFORMATION SHEET
This form must be completed before the scout can be registered for Summer Camp.
Personal information should be completed with the assistance of the parent or guardian.
Camp program information can be completed with the assistance of Troop 39 Adult Leaders.
Please USE ALL CAPITAL LETTERS when completing this form.

PERSONAL INFORMATION
                        First Name
                       Middle Initial
                        Last Name
                         Address 1
                         Address 2
                                City
                               State                              GA
                          Zip Code
                   Home Phone #
                    Home Troop #                                   39
                     Current Rank
        Date of Birth (MM/DD/YY)
     Date of Physical (MM/DD/YY)
               Medical Alert (Y/N)
                    If Yes, Explain
                 Social Security #
              Emergency Contact
                        Day Phone
                       Night Phone
        Primary Insurance Carrier
                            Policy #
                           Group #
                  Insured's Name

CAMP PROGRAM INFORMATION
        Merit Badges & Programs
                         Class 1
                         Class 2
                         Class 3
                         Class 4
                         Class 5
                         Class 6
                 Mile Swim (Y/N)
              Hunter Safety (Y/N)
2005 CAMP THUNDER
ADULT INFORMATION SHEET
This form must be completed before an adult can be registered for Summer Camp.
Please USE ALL CAPITAL LETTERS when completing this form.

PERSONAL INFORMATION
                                First Name
                               Middle Initial
                                Last Name
                                 Address 1
                                 Address 2
                                        City
                                       State                          GA
                                  Zip Code
                           Home Phone #
                        Business Phone #
                                      Fax #
                            Home Troop #                               39
                           e-Mail Address
                       Registered Position
                Date of Birth (MM/DD/YY)
             Date of Physical (MM/DD/YY)
                                        Sex
                     Religious Preference
                       Medical Alert (Y/N)
                            If Yes, Explain
                         Social Security #
                      Emergency Contact
                                Day Phone
                               Night Phone

CAMP PROGRAM INFORMATION
                  Will You Participate In
                          Safe Swim (Y/N)
                        Safety Afloat (Y/N)
                      BSA Lifeguard (Y/N)
                       Hunter Safety (Y/N)
                          Training Details
           Youth Protection Trainedg (Y/N)
         Boy Scout Leader Fast Start (Y/N)
           Boy Scout Leader Trained (Y/N)
      Boy Scout Leader Wood Badge (Y/N)
                                     Skills
     Can You Teach A Skill At Camp (Y/N)
                                If Yes, List
                                If Yes, List
Will You Provide Your Own Materials (Y/N)
                               Other Skills

				
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posted:9/25/2012
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