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South Leeds and Morley District ! Explorer Belt Expedition! Summer 2015!

! ! ! ! Application Form! ! ! !
Surname:!

Forename:

Date of birth:

! ! ! ! ! ! !

Address (inc postcode):!

Home Telephone Number:! Email Address (Parent):! Email Address (Explorer):! Explorer Unit:! T-Shirt Size:

! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! !

Why do you want to join the Explorer Belt expedition?!

! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Parent / Guardian Declarations:! ! !

What do you think you will gain from attending the Explorer Belt expedition?!

Tell us about yourself - What are your hobbies, likes or dislikes and any other interesting or unusual facts:!

I give permission for _____________________ to take part in any activities organised and supervised in accordance with the Policy Organisation and Rules of the Scout Association.! I hereby give permission for my child to attend the Explorer Belt expedition, the selection day, and any associated training and fundraising activities prior to the expedition.!

! I enclose a deposit of 50 (Cheques can be made out to Meerkat ESU)! ! ! ! !


Name of Parent or Guardian:! Signature:!

Relationship to Young Person:

! ! !

Date:

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