SCOUTING ACTIVITY APPLICATION FORM

Scouting Activity: ________________ Inclusive Dates: __________________

Venue: ______________________________________
Name of Scout: __________________________________ Registration fee: ________________
Address: ______________________________________________________________________
Cellphone No.: ________________________ Date of Birth: __________________ Age: ______
School/Institution: ______________________________ Kawan/Troop/Outfit/Circle No:______
Grade Level: ________Position in Scouting: ________________ Rank: ___________________
Father’s Name: _________________________________________ Age: ___________________
Cellphone No.: _________________________ Occupation: _____________________________
Mother’s Name: ________________________________________ Age: ___________________
Cellphone No.: _________________________ Occupation: _____________________________

PARENT’s WAIVER

I/We understand the condition and objectives of the Scouting Movement of the
Boy Scouts of the Philippines, Muntinlupa City Council where my/our son/ daughter
_________________________________________is a registered KAB/Boy/Senior Scout.
In consideration of the benefits to be derived from actively participating in the
above-stated scouting activity, I/we expressly waive any and all claims against the school and
Boy Scouts of the Philippines, Muntinlupa City Council, or its representative on account of any
untoward incident, injury or damage to personal property that may occur beyond the control of
the Contingent/Official provided that adequate safety measures and precautions have been
instituted in connection with the participation of my/our son/daughter in the above-stated
scouting activity.
I/We further agree to have my/our son/daughter meet the minimum health
requirements, including his/her physical examination by a Certified Medical Officer.

______________________________________________ _____________________
Signature Over Printed Name of Father/Mother/Guardian Date

Remark/s to be filled out by the parent:

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