BOY SCOUT APPLICATION - BSA Troop 90 Riverside CA

28-209V BOY SCOUT APPLICATION 440M304BOY SCOUT APPLICATIONI want to be a Scout. I have read the Scout Oath orPromise and the Scout Law. As a Boy Scout, I willmeet the obligations of living by the Scout Oath orPromise and will regularly attend all meetings andactivities of my Scout troop.NameBOY SCOUT UNIFORMYour official Boy Scoutuniform includes the BoyScout long-sleeve or shortsleeveshirt, Scout pants orshorts, web belt, and Scoutsocks or knee socks. Checkwith your Scoutmaster forthe headgear and neckerchiefyour troop membersmay wear. Also ask aboutthe proper insignia you willneed. Then go to your officialScouting distributor topurchase your uniform.FOLD ON LINESCOUT OATH OR PROMISEOn my honor I will do my bestTo do my duty to God and my countryand to obey the Scout Law;To help other people at all times;To keep myself physically strong,mentally awake, and morally straight.THE SCOUT LAWA Scout is trustworthy, loyal, helpful,friendly, courteous, kind, obedient, cheerful,thrifty, brave, clean, and reverent.

BOYS’ LIFE MAGAZINEFirst Issue–––––––––––––––Last Issue–––––––––––––––A Message to Parents. The youth registration fee is $10 for one year.Boys’ Life is the monthly magazine of the Boy Scouts of America. It will help your son be a good Scout and stimulatehis interest in good reading. His subscription is only $10.80 a year (half the new regular rate of $21.60 a year).Just check the Boys’ Life box on the application.Please calculate and remit the appropriate state and local taxes.On late registrations it may be necessary to deliver back issues.TEMPORARY MEMBERSHIPCERTIFICATE(Good for 60 days)This certifies that_________________________________is a member of Troop ______________________________________________Scoutmaster’s signature_________________________________DateShow this membership certificate to your Scoutingdistributor when you purchase your uniform.OFFICIAL BOY SCOUT UNIFORM PARTS*Headgear (troop option)*Neckerchief (troop option)Red shoulder loops, No. 00676Neckerchief slide (if necessary), No. 00601Khaki long-sleeve shirt, No. 58891–93Khaki short-sleeve shirt, No. 59891–93Olive web belt with buckle, No. 52992–93Green Scout trousers, No. 58008–36Green Scout shorts, No. 58108–36Green Scout socks, No. 56691–94*Unit numeral, No. 10400–08*Patrol emblem, No. 10201–40*Council shoulder patchOFFICIAL BOY SCOUT LITERATUREBoy Scout Handbook, No. 33105Fieldbook, No. 33200*Ask your Scoutmaster before purchasing these items to ensureyou have the proper uniform parts that your troop wears.*Also ask your Scoutmaster for the location of the official Scoutingdistributor nearest you, or call the Boy Scouts of America at800-323-0732 for ordering information and for credit card service.Parent Information. Your son can be a Scout if he has completedthe fifth grade, or is 11 years old, or has earned the Arrow of LightAward, but has not reached age 18.Here is how he can join:1. Complete the application (sign your name, indicating approval).2. Give the completed application and fees to the Scoutmaster.3. Secure a copy of the Boy Scout Handbook and complete thejoining requirements as listed.Health Information. Please fill out the personal health history onthe back of the troop copy of this form.SCOUTMASTER. (1) Complete and sign form;(2) retain troop copy and forward the other copyto local council service center with proper fees;and (3) sign Temporary Membership Certificateand present to member.

Welcome to the Boy Scouts of AmericaYour child is joining more than 4 million members of the Boy Scouts of America.Please take the time to review this material and reflect upon its importance.The BSA and the Chartered OrganizationThe Boy Scouts of America makes Scouting available to our nation’s youth bychartering community organizations to operate Cub Scout packs, Boy Scouttroops, Varsity Scout teams, and Venturing crews. The chartered organizationmust provide an adequate and safe meeting place and capable adult leadership,and must adhere to the principles and policies of the BSA. The BSA local councilprovides unit leader training, program ideas, camping facilities, literature, professionalguidance for volunteer leaders, and liability insurance protection.Scouting’s Volunteers and YouScouting’s adult volunteers provide leadership at the unit, district, council,and national levels. Many are parents of Scouts; many entered Scouting asyouth members. Each chartered organization establishes a unit committee,which operates its Scouting unit, selects leadership, and provides supportfor a quality program. Unit committees depend on parents for membershipand assistance.BOY SCOUTS OF AMERICAINFORMATION FOR PARENTS(On the youth’s application for membership,a parent or guardian must certify that he or she has read this information sheet.)The unit committee selects the Cubmaster, Scoutmaster, Varsity ScoutCoach, or Venturing Advisor, subject to approval of the head of the charteredorganization or the chartered organization representative. The unit leadermust be a good role model because our children’s values and lives will beinfluenced by that leader. You need to know your child’s unit leader and beinvolved in the unit committee’s activities so you can evaluate and help directthat influence.Scouting uses a fun program to promote character development, citizenshiptraining, and personal fitness for every member.You can help by encouragingperfect attendance, assisting with your child’s advancement, attending meetingsfor parents, and assisting with transportation.Program PoliciesChartered organizations agree to use the Scouting program in accordancewith their own policies as well as those of the BSA. The program is flexible,but major departures from BSA methods and policies are not permitted. As aparent, you should be aware that:• Leadership is restricted to qualified adults who subscribe to the Declarationof Religious Principle, the Scout Oath, and the Scout Law.

BOY SCOUT APPLICATIONTROOP NO. EXPIRE DATE TERM MONTHSCheck one■ New Boy Scout■ Former Boy Scout■ Former Webelos Scout■ Arrow of Light■ If applicant has an unexpired membership certificate, registration may be accomplished in this unit by paying $1 for processing the transfer. Check the box and attach certificate. It will bereturned by the council.TRANSFER FROM: COUNCIL NO. UNIT TYPE UNIT NO.Please print one letter in each space—press hard, you are making a copy.First name Middle initial Last name SuffixCountry Mailing address City State Zip codeHome phone Date of birth Grade Ethnic background School Boys’ LifeAA—African American AI—American Indian AS—AsianCA—CaucasianHI—Hispanic/Latino OT—OtherParent/Guardian information Relationship GuardianFirst name Middle name Last name SuffixSocial security numberCountry Address City State Zip codeLOCAL COUNCIL COPYHome phone Date of birth Occupation EmployerBusiness phonePrevious Scouting experienceYouth e-mail addressParent e-mail addressI have read the attached information sheet and approve the application.Signature of Scoutmaster Signature of parent or guardian DateRegistration fee $ . Boys’ Life fee $ .28-209VRetain on file for three years.

BOY SCOUT APPLICATIONTROOP NO. EXPIRE DATE TERM MONTHSCheck one■ New Boy Scout■ Former Boy Scout■ Former Webelos Scout■ Arrow of Light■ If applicant has an unexpired membership certificate, registration may be accomplished in this unit by paying $1 for processing the transfer. Check the box and attach certificate. It will bereturned by the council.TRANSFER FROM: COUNCIL NO. UNIT TYPE UNIT NO.Please print one letter in each space—press hard, you are making a copy.First name Middle initial Last name SuffixCountry Mailing address City State Zip codeHome phone Date of birth Grade Ethnic background School Boys’ LifeAA—African American AI—American Indian AS—AsianCA—CaucasianHI—Hispanic/Latino OT—OtherParent/Guardian information Relationship GuardianFirst name Middle name Last name SuffixTROOP COPYSocial security numberCountry Address City State Zip codeHome phone Date of birth Occupation EmployerBusiness phonePrevious Scouting experienceYouth e-mail addressParent e-mail addressI have read the attached information sheet and approve the application.Signature of Scoutmaster Signature of parent or guardian DateRegistration fee $ . Boys’ Life fee $ .28-209VRetain on file for three years.

Class 1 Personal Health History(Update annually, using form No. 34414.)PLEASE DETACH BEFORE COMPLETING.Identification: To be filled out by parent or guardian. Please print in ink.Name_______________________________________________________________________________________________ Date of birth______________________ Age_____Name of parent or guardian________________________________________________________________________________ Telephone_______________________________Home address ____________________________________________________ City___________________________________ State________ Zip code________________Check all items that apply, past or present, to your health history. Explain any “Yes” answers.Allergies: Food, medicines, insects, plants Yes ■ No ■ Explain: ________________________________________________________________________________________General Information: Yes NoYes NoYes NoYes NoYes NoADHD (Attention DeficitAsthma ■ ■ Convulsions/seizures ■ ■ Heart trouble ■ ■ High blood pressure ■ ■Hyperactivity Disorder) ■ ■ Cancer/leukemia ■ ■ Diabetes ■ ■ Hemophilia ■ ■ Kidney disease ■ ■List any medications to be taken at camp: _____________________________________________________________________________________________________________List any physical or behavioral conditions that may affect or limit full participation in swimming, backpacking, hiking long distances, or playing strenuous physicalgames: __________________________________________________________________________________________________________________________________________List equipment needed such as wheelchair, braces, glasses, contact lenses, etc.: ____________________________________________________________________________Immunizations (give date of last inoculation):Tetanus toxoid______________________Diphtheria ________________________Pertussis _________________________Measles __________________________Mumps __________________________Rubella __________________________Polio ____________________________________________________________Name of personal physician __________________________________________________________________________________ Telephone _________________________Personal health/accident insurance carrier ______________________________________________________________________ Policy No. _________________________Parent Authorization:This health history is correct so far as I know, and the person herein described has permission to engage in all prescribed activities, except as noted by me. In the event ofillness or accident in the course of such activity, I request that measures be instituted without delay as the judgment of medical personnel dictates.Signature ________________________________________________________________________________________________Parent or guardianDate_________________________________