Visitor Affidavit

Southern Section Ranger Kid Field Day

April 18, 2015
ALL VISITORS ARE REQUIRED TO SIGN THIS VISITORS AFFIDAVIT
VISITORS REGISTRATION: All Visitors must register. There is a $5.00 charge for those visiting on
Saturday. This Includes Lunch. Visitors will not be allowed on the grounds, should he/she decline to
complete and sign this form. This form may be duplicated, and shall be a separate attachment to the
Outpost registration, and must be presented when the Outpost registers.

Have you ever been criminally charged

sued for; rape, sodomy, sexual abuse,
contributing to sexual delinquency of
misconduct, public indecency or other

with, investigated for or

sexual battery,
a minor, sexual
such criminal offenses?

No [ ] Yes [ ] If yes a written explanation must be attached.

________________________________ __________
Visitors Signature
Date

________________________________ __________
Senior Commander
Date
Visitors Name: ________________________________________ Phone:( ___)____-________
Address: _____________________________________________________________________
City: _______________________________________ State: __________________ Zip: _______
Church: __________________________________ Section: _______________ Outpost #: ______

$5.00 Fee due: Yes[ ] No[ ]

Fee Paid:

Yes [ ] With Outpost Registration. Outpost #: _________

Yes [ ] By separate Check:___ Cash:____ Date:___/___/___
Please Remove and Duplicate this form for each Attending Visitor

Thank you for your understanding in this matter. We are trying to protect our children at all costs during this event.