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    Application Form RSVC

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    Rey Christian Butalid Arendain
    The document is an application form for a Regional Scout Venture Camp organized by the Boy Scouts of the Philippines Eastern Visayas Region from December 26-30, 2022 at Capitol Hills Scout Camp in Cebu City. It requests personal details from applicants such as name, date of birth, health information, and parental consent. Applicants are asked to provide details on any health problems, allergies, disabilities, and their COVID-19 vaccination status.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Application Form RSVC

    Uploaded by

    Rey Christian Butalid Arendain
    34 views1 page
    The document is an application form for a Regional Scout Venture Camp organized by the Boy Scouts of the Philippines Eastern Visayas Region from December 26-30, 2022 at Capitol Hills Scout Camp in Cebu City. It requests personal details from applicants such as name, date of birth, health information, and parental consent. Applicants are asked to provide details on any health problems, allergies, disabilities, and their COVID-19 vaccination status.

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    Application-Form-RSVC

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    The document is an application form for a Regional Scout Venture Camp organized by the Boy Scouts of the Philippines Eastern Visayas Region from December 26-30, 2022 at Capitol Hills Scout Camp in Cebu City. It requests personal details from applicants such as name, date of birth, health information, and parental consent. Applicants are asked to provide details on any health problems, allergies, disabilities, and their COVID-19 vaccination status.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    34 views1 page

    Application Form RSVC

    Uploaded by

    Rey Christian Butalid Arendain
    The document is an application form for a Regional Scout Venture Camp organized by the Boy Scouts of the Philippines Eastern Visayas Region from December 26-30, 2022 at Capitol Hills Scout Camp in Cebu City. It requests personal details from applicants such as name, date of birth, health information, and parental consent. Applicants are asked to provide details on any health problems, allergies, disabilities, and their COVID-19 vaccination status.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
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    BOY SCOUTS OF THE PHILIPPINES

    EASTERN VISAYAS REGION

    REGIONAL SCOUT VENTURE CAMP


    26-30 December 2022
    Capitol Hills Scout Camp, Cebu City

    APPLICATION FORM FOR PARTICIPANTS

    Local Council: __________________________

    PERSONAL DETAILS

    Name: ___________________________________________________________________
    Last Name Given Name Middle Name
    Sex: _______ Date of Birth: __________________ Place of Birth: ____________________
    Height: ____ Weight: _____ Blood type: ______ Nationality: ________ Religion: _________
    Father’s Name: ______________________ Mother’s Name: ______________________
    School or profession: _____________________ Grade or level of education: ____________
    Home address: _____________________ City address: ____________________________
    Tel. No: __________ Mobile No: ____________ Email: _____________________________
    Special Skills/Qualifications: __________________________________________________

    _______________________________________
    Applicant’s Signature over Printed Name
    Date: ________________

    PARENT’S/GUARDIAN’S CONSENT
    (for minor applicants)

    We hereby approve this application and certify to its correctness. In consideration of


    the benefits to be derived, we expressly waive any and all claims against the Boy Scouts of
    the Philippines or its representatives on account of any incident or injury or damage to
    personal property that may occur beyond the control of the Contingent Officials/BSP
    provided adequate safety measures and precautions have been instituted in participation in
    the Regional Scout Venture Camp.

    _______________________________________
    Signature over Printed Name of Parent/Guardian
    Date: ________________

    HEALTH DETAILS

    Special Health Problem (Do you have any of the following illnesses?)
    ☐ Heart disease ☐ Hay fever ☐ Diabetes ☐ Hypertension ☐ Fainting
    ☐ Haemophillia ☐ Asthma ☐ Epilepsy ☐ Sleep Walking ☐ Autism
    Any allergies: __________________________________________
    Any physical disability: ___________________________________
    Others: _______________________________________________
    Recommendations and/or restrictions (if none, so state): ____________________________

    COVID-19 Vaccination Status (Please attach copy of COVID-19 vaccination card)


    ☐ Fully vaccinated (w/ or w/o booster) ☐ Partially vaccinated ☐ No vaccination
    Note: Participants not fully vaccinated must present negative COVID-19 antigen test result upon arrival.

    Physician (signature over printed name): ________________________


    License No: _________

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