2023 LEADER'S GUIDE CAMP THUNDER RIDGE SCOUTS BSA

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2023 LEADER'S GUIDE CAMP THUNDER RIDGE SCOUTS BSA
CAMP THUNDER RIDGE
        SCOUTS BSA   2023
            LEADER’S GUIDE
2023 LEADER'S GUIDE CAMP THUNDER RIDGE SCOUTS BSA
2023 Leader’s Guide

       CAMP THUNDER RIDGE
              CONTACT INFORMATION

            Website: utahscouts.org/thunderridge

        CAMP RESERVATIONS AND INFORMATION
                   TERRI COMBER
                   Camping Assistant
              program.office@scouting.org
                    (801) 476-5460

          CAMP FEE PAYMENT INFORMATION
     For mailing payments use the following address:
              Crossroads of the West Council
                      1200 E 5400 S
                    Ogden, Utah 84403
                For online payments visit:
                     utahscouts.org

            THUNDER RIDGE CAMP DIRECTOR
                       EMILY HILL
                 emiline882@gmail.com

                    DRIVING LOCATION
                   UT-143, Mile Marker 12
                      Brian Head, UT

             CAMP THUNDER RIDGE
      EMERGENCY PHONE DURING CAMP SEASON
                 (801) 420-1811

 Portions of Camp Thunder Ridge’s operations are on National
  Forest lands and are authorized under special use permit by
the Dixie National Forest and operates on a non-discriminatory
                             basis.

Camp Thunder Ridge does not discriminate against anyone on
  the basis of race, color, national origin, religion, age, sex,
       handicap, or any other delineation of peoples.
2023 LEADER'S GUIDE CAMP THUNDER RIDGE SCOUTS BSA
THUNDER RIDGE
                   CAMP OVERVIEW
   Situated at 9,500 feet above sea level, Camp Thunder Ridge has
   breathtaking views of the surrounding landscape - unique to Iron
County. The camp We enjoy more than 1500 acres of mountains and
 meadows. Our 9500 ft. elevation gives us a breathtaking view of the
surrounding national forest. Cedar Breaks National Monument is just a
                            few miles away.

 Thunder Ridge is nationally accredited by the Boy Scouts of America.

              2                250             9,500
       Weeks to choose        Total camp         Feet above
       from during 2023.     capacity each        sea level.
                               session.

          6   Miles from Cedar Breaks National Monument.

              Campsites located in aspen and pine meadows
         27
              Typical summer daytime high temperatures with
Low 80’s      nighttime lows in the 50’s.

THUNDER RIDGE IS…
ADVENTURE: We delight in the thrill of discovery and helping others discover their own adventures.
ENTHUSIASTIC: We love Thunder Ridge and we joyfully do our best to make each session the most
exciting camp experience ever.
DIVERSE: We value all people and celebrate the differences that make us all special.
FRIENDLY: We reflect the values of the Scout Oath and Law in all that we do.
SERVICE DRIVEN: We are happy to be here and honored to serve you.
2023 LEADER'S GUIDE CAMP THUNDER RIDGE SCOUTS BSA
PLANNING FOR CAMP
We are very happy you have chosen Camp Thunder Ridge for your upcoming Scout camp! We
promise to do all in our power to make your Scout camp memorable and successful. We have found
the best Scout camps are those planned together by youth and leaders. One way to structure your
leadership is outlined below.

Scoutmaster
As the adult in charge of your event, it is your responsibility to oversee the entire organization and
development of the event and to see the goals of the event are met. We encourage you to keep a low
profile. Let the youth plan their own agenda as much as possible. There will be times when your
expertise and experience will be needed, so don't hesitate to offer suggestions and ideas to smooth
out the rough spots. Youth want to show that they are capable and will do an excellent job when
given the opportunity.

Senior Patrol Leader & Patrol Leaders
As youth leaders, you have one of the most important jobs. Scout camp may have more influence on
your peers than any other activity held during the year. You are responsible for overseeing the
planning and conducting of the events while at Camp Thunder Ridge. Remember to keep the goals
for the events in mind when planning. Be prepared for committee meetings and set specific tasks to
reach your goals.
       Prior to camp
           • Work with adult leaders
           • Develop goals and themes
           • Coordinate all committees
           • Follow deadlines
       During the camp
           • Work with Camp Thunder Ridge Staff
           • Conduct all meetings
                  • Orientation & general meetings
                  • Special meetings (firesides, testimonies, etc.)
           • Encourage peers to follow camp rules
           • Keep records of advancement & participation (Fellowship of Thunder Ridge, etc)
Adult Supervisors:
We strongly urge you to plan sufficient adult supervision for the size of your Scout camp group.

Schedules:
Please consult the week at a glance schedule. Camp Thunder Ridge offers activities throughout the day,
including evening programs, merit badge activities and advancement programs.
2023 LEADER'S GUIDE CAMP THUNDER RIDGE SCOUTS BSA
PLANNING FOR CAMP
Pre-Camp Checklist
   16 weeks before camp - Parent’s night conducted to inform parents of camp
   plans
   Early Spring - Watch the Camp Thunder Ridge pre-camp video on YouTube
   12 weeks - Leadership arranged, two-deep leadership at all times
   May 1- Half of your group’s camp fees are due to Crossroads of the West
   Council
   May 2 - Online merit badge registration opens
   8 weeks - Remind parents that all camp attendees need health forms
   8 weeks - Participants have personal equipment list
   4 weeks - Health & medical record completed for each youth & adult (Parts A, B,
   and C)
   4 weeks - All youth and adults are registered with your Troop
   4 weeks - Transportation arranged and insurance verified
   4 weeks - Group camping equipment ready
   1 week - Final camp fee and participant number adjustments due
   1 week - Print group roster and bring with you to camp
   Day of arrival - Bring: Adults & Scout Medical forms, and verified group roster to
   checkin at office. Be sure numbers are accurate and balance is paid
2023 LEADER'S GUIDE CAMP THUNDER RIDGE SCOUTS BSA
PROGRAM OPPORTUNITIES
                            Along with the great location and staff at Camp Thunder Ridge, camp
                            programs are the best anywhere! Scouts and leaders will be challenged to fit
                            merit badge courses, free- time elective activities, and special programs into a
                            busy week of camp. Pre- planning is essential. Check out our great programs.

                            Flag Ceremonies
                            These include fun, games, and a chance to show off your Troop spirit.
                            Information concerning the day’s activities will be presented and scouts will be
                            able to experience patriotic ceremonies and build their appreciation for our
                            great country.

   Buddy System
                            Troop Service Projects
All campers should have
a buddy while at camp.      If desired, we provide opportunities for your Unit to do service projects while in
Your buddy has your         camp. Many Troops feel this is an important part of their summer camp
back and you have your      experience. Projects can range from very simple to more complex. Often adults
buddies back! Watch out     with special talents can do more intricate and exacting work. The camp will
for, and help each other.
                            tailor projects to your Troops’ age and skill. We are always looking for people
                            who would like to help Camp Thunder Ridge become even better. Anyone
                            interested in joining our support team, please notify the Camp Director. All
                            aspects of support can be used and are greatly appreciated.

                            Leader’s Training
                            Throughout the week, our staff will provide Round Tables which are open to all
                            adult leaders, and the camp will also offer; Youth Protection certification and
                            Backcountry Ethics instruction.

                            Campsite Inspections
                            Campsites will be inspected each day by the commissioner and Senior Patrol
                            Leaders within each Commissioner area. The purpose is to improve health and
                            safety, patrol method, and scout spirit.

                            Campfires
                            There will be campfire programs for the entire camp on Monday and Friday
                            nights performed at Thunder Ridge’ s fabulous fire bowl. On Wednesday
                            nights, Commissioners will direct campfires where each troop will perform for
                            the troops assigned to each commissioner area. Check with your Camp Friend
                            for ideas for skits and songs to be ready to show the camp. The Commissioner
                            will need to review and approve all skits and songs.
2023 LEADER'S GUIDE CAMP THUNDER RIDGE SCOUTS BSA
PROGRAM OPPORTUNITIES
Hike Day
On Wednesday, each Troop will be given an opportunity to leave camp for the
day.

Hikes include:

•   CEDAR BREAKS NATIONAL MONUMENT - Camp Thunder Ridge is only
    6 miles (20 minutes) from this local treasure! Hidden within the mountains
    above Cedar City is the brilliant geology and vibrant environment of Cedar
    Breaks National Monument. The geologic amphitheater and surrounding
    environs are home to cool hiking trails, ancient trees, high elevation
    camping, and over-the-top views along the “Circle of Painted Cliffs.”

    Cedar Breaks’ majestic amphitheater is a three-mile-long cirque made up of
    eroding limestone, shale, and sandstone. Situated on the western edge of
    the Markagunt Plateau, the raised area of earth located in Southern Utah
    between Interstate 15 and Highway 89, the monument sits entirely above
    10,000 feet. The Amphitheater is like a naturally formed coliseum that
    plunges 2,000 feet below taking your eyes for a colorful ride through arches,
    towers, hoodoos, and canyons. Stunning views are common throughout so
    keep your camera nearby.

    Units are responsible for NPS entrance fees. A complete list of hikes within
    the national monument are found online at https://www.nps.gov/cebr/
    planyourvisit/hike-a-trail.htm

    Units on the dining hall plan will receive a sack lunch to eat while exploring
    the monument. Groups are encouraged to bring lots of drinking water,
    sunscreen and hat to protect you from high-elevation sun.

•   BRYCE CANYON NATIONAL PARK - Camp Thunder Ridge is only 62 miles
    from this one-of-a-kind national park. An alpine forest with as many red
    rock hoodoos as trees. At dawn and dusk, mule deer graze the forested
    plateau along the road into Bryce Canyon. The alpine environment is home
    to dozens of species of mammals and birds, all acquainted with a
    spectacular truth: this is no ordinary forest. Water and wind over millions of
    years of freezes and thaws, have carved into the plateau endless fields of
    distinctive red rock pillars, called hoodoos, as well as into the park's series
    of natural amphitheaters.

    Units are responsible for NPS entrance fees. A complete list of hikes within
    the national monument are found online at https://www.nps.gov/brca/
    planyourvisit/day-hikes.htm

    Units on the dining hall plan will receive a sack lunch to eat while exploring
    the monument. Groups are encouraged to bring lots of drinking water,
    sunscreen and hat to protect you from high-elevation sun.
2023 LEADER'S GUIDE CAMP THUNDER RIDGE SCOUTS BSA
PROGRAM OPPORTUNITIES
•   MARKAGUNT PLATEAU VOLCANIC FIELD - The Markagunt Plateau is
    one of the forested highlands that make up the High Plateaus section of the
    Colorado Plateau. The Markagunt covers about 800 square miles mostly
    within Dixie National Forest, including Cedar Breaks National Monument.
    The ski resort town of Brian Head is its highest point at 11,307 feet.
    Markagunt was named for the Paiute word meaning “Highland of Trees.”

    Volcanic activity on the eastern Markagunt Plateau began about 5 million
    years ago and continued until as recently as 1,000 years ago. Evidence of
    volcanic activity is scattered throughout the plateau. The Markagunt Plateau
    volcanic field, located east of Cedar Breaks National Monument, is a group
    of cinder cones and lava flows. The youngest cinder cones are located near
    Panguitch Lake in the north and Navajo Lake in the south. Navajo Lake was
    actually formed when a lava flow formed a dam at Duck Creek. Mammoth
    Cave, which formed 2,000 years ago and is located about 22 miles south of
    Panguitch Lake, is one of the largest lava tubes in Utah.

    Units on the dining hall plan will receive a sack lunch to eat while exploring
    the lava flow. Groups are encouraged to bring lots of drinking water,
    sunscreen and hat to protect you from high-elevation sun.

•   HENDRICKSON LAKE HIKE - This trail climbs quickly through stands of
    large fir trees. It passes by several springs and starts into a series of switch
    backs, climbing quickly to the top of the hill west of camp. Aspen is the
    dominant tree species as the trail climbs a small hill and overlooks
    Hendrickson Lake, a beautiful natural lake with a good population of
    catchable Brook trout. The trail skirts around the east side of the lake where
    it enters a thick stand of mixed conifers and aspen.

Camp-Wide Games
All Troops are invited to participate in games and skill activities conducted by
the staff on Thursday evening. This is a chance to have a positive interaction
with all the other campers at Thunder Ridge and an opportunity to build team
and scout spirit.

Scout Craft Skill Events
All troops are invited to meet with their commissioner and camp friends on
Tuesday evening, to show off and practice their scout craft skills. Events are
held on the Commissioner area level with four or five troops participating and
everyone given a chance to play.

Order of the Arrow
The Order of the Arrow (OA) is Scouting’s National Honor Society. A major
component of the OA is camping and camp promotion. The Council’s OA
Lodge, the Ammatdiio (Ah-mah-Di-yo) Lodge will have representatives available
at camp to perform unit elections, or answer any questions you may have. If
you are a member of the OA, bring your sash and wear it on OA day!
2023 LEADER'S GUIDE CAMP THUNDER RIDGE SCOUTS BSA
RANK ADVANCEMENT
The primary responsibility for rank advancement is that of the unit leaders and
the unit committee. Camp Thunder Ridge assists Unit leadership by providing
the finest in instruction and counseling. Although staff instructors and
counselors will provide accurate records for information covered and skill
accomplished, it is the responsibility of each unit leader to mark rank
advancements in each youth’s individual record (usually in their handbook).
Camp counselors will also sign merit badge cards, but the Unit is responsible
to ensure they are properly recorded in each youth’s permanent record.

Advancement Policies
All advancement will be in accordance with BSA National Standards. Merit
badge counselors and instruction will be supervised by trained Directors, 18
years of age or older. Blue cards for completed merit badges will be provided
by Camp Thunder Ridge. Those not completing all requirements for a specific
merit badge will be given partial completion slips. Boards of Review may be
conducted in camp if adequate adult leadership is available. Appropriate adult
representation on the board, however, is the responsibility of each Unit. The
Scoutmaster, Advisors or Skipper is responsible to prepare, monitor, and verify
completion of the Scout’s advancement. Preparing for each merit badge by the
Scout is highly encouraged and work done before camp is acceptable. Any
Scout receiving a merit badge from Camp Thunder Ridge will know the subject
matter and have learned the practical skills associated with the merit badge.

NOTE: Unit leaders are given an opportunity to review all advancement records
before leaving camp and are encouraged to review them at home and give the
records and cards to the Unit Advancement Chairman.

Trail to First Class Program
The first year camper program at Camp Thunder Ridge is designed to provide
new and young Scouts a program where they can learn basic Scout skills.
Many of the skills taught will complete requirements for Tenderfoot to First
Class ranks; however, we recommend that all campers participate in these
activities. Activities in this program are offered during the third merit badge
time slot, or are available to all Scouts during Tuesday, Thursday, and Friday
free time periods. Specific requirements are posted towards the end of this
guide.

Merit Badge Program
The following is a list of merit badges offered at Camp Thunder Ridge. Any
registered merit badge counselor who would like to offer or teach additional
badges while at camp is welcome. Please contact the Program Director. For all
badges listed below, the camp provides staff counselors and instructors.
2023 LEADER'S GUIDE CAMP THUNDER RIDGE SCOUTS BSA
RANK ADVANCEMENT
Class Time Offerings
• Trail to First class - Class hour #1, 2, 3
• Archery - Class hours #1, 2, 3
• Astronomy - Class hours #2, 3
• Chess - Class hours #1, 3
• Orienteering - Class hours #2
• Geocaching - Class hours #1, 2, 3
• Rifle shooting - Class hours #1, 2, 3
• Shotgun shooting – Class hours #1, 2, 3
• Climbing - Class hours #1-2, 2-3 (this merit badge takes 2 class hours)
• Emergency preparedness - Class hours #2, 3
• Environmental science - Class hours #1, 2, 3
• First aid - Class hours #1, 2, 3
• Fish & wildlife - Class hours #1, 3
• Forestry - Class hours #1, 3
• Indian lore - Class hours #1, 3 ($)
• Leatherwork - Class hours #2, 3 ($)
• Mammal study & Nature - Class hours #1, 2
• Pioneering - Class #1, 2
• Search and rescue - Class #2, 3
• Wilderness survival - Class hours #1, 3
• Wood Carving - Class #1, 2
• ACE - Class #1-3

DURING “FREE TIME” the Rifle, Shotgun, and Archery merit badges are not offered
but all others are available with the addition of:
• Basketry ($)
• Bird Study
• Geology
• Soil and Water Conservation
• Weather

Camping, cooking, and hiking merit badges are signed off by the Scout’s own Unit
Leaders.

Merit Badge Preparation
Some Merit Badges have requirements that cannot be completed in a week of
summer camp. If your Scouts are interested in finishing any of these at camp,
ensure the following requirements are completed prior to arriving at camp.
   • Emergency Preparedness - requirements #2c and #8b
   • Nature - requirement #4
   • Personal Fitness - requirements #8 and #9
   • Sports - requirements #4 and #5
CAMP LIFE
Special Needs Requests
All special medical conditions should be reported to the health officer upon
arrival in camp. If there is a camper with special needs, please contact the
camp director so we can make the appropriate accommodations.

Campsite Accommodations
Each campsite has a picnic table (or more) and campfire pit. Participants and
groups need to plan on bringing their own tents. We encourage groups to
bring wagons or wheel barrows to get your equipment from the parking lot to
your campsite.

Latrines
Camp Thunder Ridge provides portable toilets and some flushing toilets.
Please do not throw any garbage down the toilets. This includes: feminine
hygiene products of any kind (pads, inserts, applicators, or wrappers). Hand
wipes or baby wipes, toilet paper rolls, wrappers, candy wrappers, or food
items should not be put in the latrine. If there are any of these items found in
the toilets, it is extremely difficult to clean them out and the pumpers will refuse
to clean out. There are garbage cans in every building, please use them.
When the garbage cans get full, please empty and replace the can liners.
There are extra garbage bags and toilet paper in the dining hall.

Water
Each campsite has a nearby water spigot with potable water. Encourage your
participants to stay hydrated!

Ecology
Please make certain that all group members understand the delicate balance of
plant and animal life in the wilderness. Everyone should do their best to ensure
that no animals are molested or killed - this applies to aquatic as well as land
life.

No pets of any kind should be brought to camp. Pets are a threat to wildlife
and are in danger themselves.

Never cut down a tree, dead or alive. Do not carve names or symbols into the
trees or do anything else that could damage the trees.

Cliff Edge & Tree Climbing
Camp Thunder Ridge has a strict no cliff edge & tree climbing policy.
Participants (youth or adult) that are discovered to be climbing cliff edges or
trees will be sent home.
CAMP LIFE
                             Hammocks
                             Those that wish to use hammocks at camp must provide their own free-
                             standing frame. Adults are encouraged to ensure a hammock’s set-up is safe
                             for the individual using the hammock.

                             Fire
                             The smallest spark is a deadly threat to wildlife and campers. No fireworks are
   PETS ARE NOT
                             allowed in camp. All fires must be confined to the designated fire pits in each
     ALLOWED                 campsite. Restrictions are posted online at www.utahscouts.org/safety.
No pets are allowed in
camp at any time except      Firewood
service animals.
                             There is plenty of dead and down wood in our forest that you may find and use
                             for your fires. Groups are encouraged to bring their own saws or axes to cut
                             wood for their campsite.

                             Quiet Hours
                             We are required to provide all campers with at least nine hours of quiet time.
                             Between 10:00 PM and 7:00 AM each day we ask that you enforce this quiet
                             period.

                             Showers
                             The centralized shower house provides individual showers and dressing rooms
   TRADING POST              for all campers. Maintenance of the facility is the responsibility of all who use
                             it. Report any malfunctions to the Camp Director at once. Please help
The Trading Post is
                             everyone do their part to keep the showers clean and safe. Adults should be
stocked with merit badge
kits, snack items, drinks,   aware of their group’s behavior and control discipline by providing supervision
ice cream, candy, t-shirts   while your group is at the shower facility. If there are any difficulties with other
and other items.             campers; please contact the staff.

                             Depending on the groups in camp each week, will depend on which bathrooms
                             are designated for boys and which are designated for girls. This will be clearly
                             marked and your group will be informed at check-in which bathrooms will be
                             designated male and female.

                             Groups who share the use of each facility are all responsible for cleaning it
                             daily. Health, safety and cleanliness are everyone’s responsibility.

                             Vehicles, Trailers, and Parking
                             Vehicles parked on camp property must display a camp vehicle registration
                             card that will allow camp staff to contact the owner/operator in the event of an
                             emergency or other need. These registration cards are attached to this packet.
FOOD SERVICE
It is our hope to serve you well while you’re at Camp Thunder Ridge. Our Staff
is here to be of assistance to you.

Dining Hall
This service includes three balanced meals prepared by our cooks, each day.
Reservations for guests must be made and paid for in advance: $8.50 per meal.
Participants must be washed and wearing full uniform is encouraged for
evening meals. Units will be on a rotation for after-meal cleanup.

Bring Your Own Food
Simple: you bring it, you prepare it, and you store it. Food storage will be your
responsibility.

When washing dishes, use hot water. It is recommended that to wash and
rinse in an approved disinfectant after all meals. Allow each dish to air dry.
After drying, store in a clean place. This will prevent diarrhea and other contact
diseases.

Food storage will be your responsibility.

Dietary Restriction Accommodations
If you have someone in your group who has special dietary restrictions to items
posted on our menu, fill out the allergy form online at www.utahscouts.org/
allergy Please do this no later than 2 weeks prior to arriving at camp to help us
meet dietary needs. If our staff have concerns about accommodating your
particular allergy or dietary needs you will be contacted.

Menus
Menus will be posted online by early Spring.
HEALTH & SAFETY
Emergency Procedures
In any large-scale operation, there exists the possibility of “emergencies.” This procedure is to help the
staff and leaders perform efficiently in any emergency and keep everyone informed.

Weather-Related Emergencies
Camp Management makes every reasonable effort to monitor weather conditions that may pose a
threat to the health and safety of the camp. Leaders are ultimately responsible for the safety of their
participants, and are strongly encouraged to use good judgment when a possible threat exists.

Weather Impact on Activities
Occasionally, camp program and activities will be impacted by weather events. Thunder & lightning in
the vicinity of camp can cause us to “delay” or “cancel” these activities. We do not take your safety
lightly! Decisions to close an area are usually determined by the area director, in consultation with the
Camp Director.

As always, we depend on our unit leaders to be aware of any weather activity that they deem may
impact the safety of their participants. If you as a leader determine that you need to move your
participants from an area, or move off an activity field, we encourage you to do that and not wait for a
decision from the Staff.

Fires
Campers and staff should be careful with fire. In the event of a fire, the camp alarm will broadcast.
Please make sure that everyone in your unit knows that when they hear the alarm, they should go
immediately to the parade grounds east of the lodge and assemble there. Do not try to find each other
around camp. The camp administration will then provide directions about how to proceed. An
emergency drill is normally held within 24 hours of each arrival group.

Lost or Missing Person
If a youth or adult is believed to be missing, adult leaders should first confirm that the missing person
is not in the campsite, activity areas, or other common gathering places about camp. The group
should utilize the following steps: Assemble Your Group, Check Each Tent, Check Areas, then if not
found, notify a staff member immediately.

Other Emergencies
Depending upon the nature of the emergency, camp staff will communicate necessary information to
the camp, based on the nature of the threat.
CAMP POLICIES
Camp Thunder Ridge follows the National BSA policies on Youth Protection.
The BSA has adopted the following policies for the safety and well-being of its
members. These policies primarily protect youth members; however, they also
serve to protect adult leaders.

Two-Deep Leadership
Two adult leaders 21 years of age or over are required at all times while at
camp.

No One-On-One Contact
One-on-one contact between adults and youth members is not permitted. In
situations that require a personal conference, the meeting is to be conducted in
view of the other adults and youth.

Respect of Privacy
Adult leaders must respect the privacy of youth members in situations such as
changing clothes and taking showers at camp and intrude only to the extent
that health and safety requires. Adults must protect their own privacy in similar
situations.

Tenting Accommodations
Separate tenting arrangements must be provided for male and female adults as
well as for male and female youth.

Youth sharing tents must be no more than two years apart in age. Youth and
adults must tent separately. Spouses may share tents.

Group Discipline and Adult Supervision
The role of the camp staff is to provide the summer camp program and all of
the other camp infrastructure needed to ensure a safe and enjoyable stay at
camp. As with any group outing, the adult leadership of each group is
responsible for the behavior of their participants. Please help the staff focus on
program by watching your participants and being available to deal with
discipline issues should they develop.

Insurance
   •   Each group is required to carry adequate and proper liability insurance.
   •   Scouts BSA and Venturing members registered in the Crossroads of the
       West Council are already insured - so nothing is required.
   •   Please prepare to verify that each camper is protected with personal
       health insurance - ensure that policy numbers are listed on each medical
       form.
CAMP POLICIES
                             •   Groups must have two-deep leadership at all times while at camp. No
                                 exceptions!

                             •   No fireworks of any kind are permitted on camp property.

                             •   No flames, fires, or fuels of any kind are permitted inside tents.

                             •   Throwing rocks is strictly forbidden.

                             •   Personal firearms and bows are not permitted, please leave them at
     VALUABLES                   home.

Please remember to           •   All vehicles must be parked in the designated camp parking areas. Only
safeguard your valuables         authorized vehicles are allowed on the roads through camp.
while at camp.
                             •   No alcoholic beverages or illegal substances are allowed on camp
A locked vehicle in the          property.
parking lot may be used to
store your group’s
valuables.
                             •   Shoes must be worn at all times at camp and must not be open at the
                                 toe or sides. Sandals are allowed only at the showers.

                             •   No sheath knives – leave them at home.

                             •   No LASER (pens/pointers) of any kind are permitted in camp.

                             •   All guests are required to immediately check-in at the Camp Office.

                             •   Refer to the Boy Scouts of America Guide to Safe Scouting for
                                 additional policies.

   TECHNOLOGY                •   Smoking - all buildings and tents are smoke-free. There are designated
                                 smoking areas for those who smoke.
Participants are
encouraged to                •   Swimwear - participants are encouraged to wear swim wear that is
appropriately document           suited for active water sports such as swim trunks or board shorts for
and share their                  males and one-piece suits or tankinis for females.
experiences during their
stay.

Please remember, there is
no power outlets for
guests to use to charge
their devices.
FREQUENTLY ASKED QUESTIONS
How do I make changes to my registration including merit
badge classes?
The person named on the registration has access to the system to add and
change participant numbers, make payments and add and change merit
badges. A user ID and password is required. You can add and subtract youth
to your registration and make payments online up to 5 days before your camp
date. Visit “How to create or make changes to camp registration” on your
camp's webpage to download instructions. The system will lock the leader out
at 5 days before camp. Number changes within the 5 days must be done by
the Council's service desk at 801-479-5460 or program.office@scouting.org.
Any changes to merit badges within that 5 day period must be done at camp
check in.

When can we sign up for Merit Badges?
The merit badge system goes online the first Monday of May at 8 am. You must
have your half balance owed paid and your Scouts named and added to the
registration roster before the system will let you proceed. You can do that any
time before May 1. If you make additions at the same time as doing the merit
badge sign ups, you will need to pay the half balance with a card before the
classes will save. You must go through all steps of “Check Out” to finalize your
order. Be sure you get a receipt to confirm your class choices were saved and
finalized.

What do I do for checking out of camp?
Check out: Friday afternoon/evening or Saturday a.m. Receive back health
forms, camp totems and clear account. Receive link to Refund Credit Request
if needed. Don't forget to go online to make your registration for next year and
get your choice of camp and dates!

What are the swim check requirements?
Camp Thunder Ridge does not have an aquatics program.

Changes:
Changes and payments to registration or merit badges can be made online up
to 5 days before camp. Within those 5 days changes or payments HAVE to be
made through the Council's service desk.

Changes to merit badges within the 5 days prior must be done at camp on day
of check in. Final payments should be paid prior to camp check in. Youth
added at camp will have a $10 late fee added.
FREQUENTLY ASKED QUESTIONS

What do I bring for check-in?
• Health and medical forms for youth and adults – Parts A,B & C. All adults in
  camp 72 hrs or more must have a physical (part C of health form). Note: to
  swim, hike and participate in most camp activities - participants (youth &
  adults) will need to have all 3 parts of the BSA health form (including
  physician physical).
• Copy of registration showing paid in full.
• Group roster showing all youth and adults attending – youth and leaders
  must be verified of BSA Scout membership at the Council office 4 weeks
  prior. Visit utahscouts.org/camproster to submit your roster online for
  verification.
• Any adult in camp 72 hrs or more, needs to be BSA registered prior to camp
  date. This includes parents.
• Final payment – cash, check, or card. We prefer final payment be made
  online before camp.

Can I add people to the registration at check-in?
Yes, you may add additional participants at camp check-in. There will be a $10
late fee to add them. We suggest you do not pay for someone you are not sure
if they are attending. Pay for them at check-in to avoid losing your fee if they do
not come. Merit badges can be added at check-in.

Can I get a refund if I over pay?
A credit to for next years camp is possible in place of a refund. If you paid for
more youth than came to camp, be sure to request a credit when you return
home from camp. Be VERY specific as why the participant did not come. The
online form is available at www.utahscouts.org/campcredit. You will receive a
letter (emailed to whoever fills out the form) in September explaining if the
request for a credit will be accepted or denied according to your reason for
absence. Remember, you may adjust your numbers online up to one week
before camp. Be sure your numbers are as accurate as possible to prevent
over payment.

Will I receive additional information?
The camp director will send out monthly emails with camp information starting
in January, watch your email for that information.
Eagles Nest Trail              Rifle Range
Brian Head
                                                      Parking Lot                                             Archery Range                                            Climbing & Little Thunder Lake

                                                                                               Upper Pavilion
                                                                                                                                                                          Lake Hendrickson Trail

                                                                                                                                                        Low C.O.P.E.

                                Chapel                        Showers                  Ropes Course
                                                                                                                                               Eccles Nature Center

                                  First Aid                       Amphitheater

                                                                                                                                  North Pavilion

                     Commissary

        Blackburn Lodge                                                                                            Hopi (XL)

                                                                                                            Seneca (XL)
                 Trading Post
                                                                                          Tuscarora (XL)
                                              Parade Grounds                                                       Roanoke (XL)
                                                                                  Apache (XL)
                                                                            Ute (XL)
 Lower Amphitheater
                                                                  Washakie (XL)
                                                      South Pavilion                                     Seminole (XL)    Quapaw (L)

                                                                 Yakutat (M)
                                                                                                    Navajo (L)
                                     Dakota (XL)
                                              Flathead (XL)                    Zuni (M)    Oneida (L)
             Blackfoot (L)   Comanche (L)
                                                        Gros Venture (M)
                                                                                                                                                   DIXIE NATIONAL FOREST
                                                                                                                     Pawnee (L)

                                                                                                        Pima (M)

                                                                                          Onondada (M)
                                                                        Nez Perce (M)
                                          Havasupi (XL)

                                                       Mandan (M)
                                                                                                                    CAMP THUNDER RIDGE
                                                                                                                     CROSSROADS OF THE WEST COUNCIL
THUNDER RIDGE                                                                                                    WEEK AT A GLANCE
             6:30       7:30      8:30       9:30     10:00     11:00         12:00      1:15        2:30        3:30      4:30      6:00    7:00        7:30   8:00              8:20        8:30        9:00       10:00
                                                                                                                                                            SPL &
                                             Scoutmaster Check-in                           L                                                                                     Fire                    Opening
 Mon                                                                                                 Class 1    Class 2    Class 3                         Leaders                                        Campfire
                                                 Set up camp                                u                                                                                     Drill
                                                                                                                                                           Meeting                             Flag
            Sunrise                                                                         n                                                                                                Ceremony
                                   Camp      Flag               Class 2                                                                                                                                   Fellow-
                                                                                                                                                                                                                      Q
            Hike to                                                                         c                                                            Commissioner Scout
 Tues                             Inspec-    Cere-   Class 1                  Class 3                          Free Time                                                                                   ship       u
            Eagle's                                                                         h                                                               Craft Skill
                             B      tions    mony               SM Mtg                                                                D                                                                  Induction    i
             Nest
                             r                                                                                                        i                                                                               e
                             e                                  Hike & Adventure Day                                                  n          Troop                   Flag                  Commissioner           t
 Wed                                                                                                                                  n                                                          Campfire
                             a                                         Lunch on the Trail                                                       Activities             Ceremony
                             k                                                                                                        e                                                                               T
                             f                                 Class 2                                                                r                                                                               i
                                                                                            L                                                              Flag        Campwide
 Thur       Sunrise                                  Class 1                  Class 3                                                                    Ceremony                              Honor Trail            m
                             a     Camp      Flag                                           u                                                                           Games
                                                               SM Mtg
            Hike to          s                                                                                 Free Time                                                                                              e
                                  Inspec-    Cere-                                          n
            Eagle's          t      tions    mony              Class 2                      c
             Nest                                                                                                                                                        Flag                    Closing
   Fri                                               Class 1                  Class 3       h
                                                               SM Mtg                                                                                                  Ceremony                  Campfire
                                            Notes:                                                                                          Trail to First Class/First Year Camper
                                                     Flag Ceremony       ____________________                                               Mon - Pathfinder (Orienteering)
                 Breakfast @ 7:30                                                                                                           Tues - Commando Corps (Outdoor Skills)
  Sat        Checkout begins at 5-10 AM
                                                     Service Project     ____________________                                               Thurs - Naturalist (Nature)
                                                                                                                                            Fri - First Responder (Outdoor Skills)
Nature                           Outdoor Skills                Field Sports             Handicraft              Climbing                    Wilderness Survival                 Thursday 10:00
Environmental Science            First Aid                     Rifle                    Wood Carving            Climbing
Forestry                         Emergency Preparedness        Shotgun                  Leatherwork             ACE                         Star Party              Tues & Wed @ 10:00
Mammals/Nature                   Wilderness Survival           Archery                  Indian Lore
Astronomy                        Pioneering                    Orienteering             Metal Work                                          OA Social               After Commissioner Campfire
Fish & Wildlife Management       Search & Rescue               Geocaching               Chess                                                                       For any Scout that is in or interested in OA
                                 Trail to First Class
Camp Thunder Ridge
                                          Unit Roster
  Instructions:

  • This form is to be used by groups attending Camp Thunder Ridge programs and to be submitted at camp during check-in.
  • Complete the form by listing the youth and adults that will attend Camp Thunder Ridge programs.
  • For Scouts BSA groups: verify BSA membership registration for each youth and adult through local BSA Service Center. This must be
    verified: in person, emailed (program.office@scouting.org), at least 1 week prior to attending camp.
  • Attach receipt for payments made within 7 days prior to arrival.

Unit # _________ Camp: _________________ Camp Date: __________ District: __________________

Unit Leader Name (First & Last): ___________________________________________________________
Mailing address: ________________________________________ City: ________________ State: _____
ZIP: ________________ Phone: ( ___ ) ________________ Email: ______________________________

Adult Leader Names & Email

_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________

Other Adults or Parents & Email

_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________

Youth Names & Parent’s Email
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
All youth & adults that attend camp must be registered members of the Boy Scouts of America. If a youth or adult is not currently
registered when this roster is verified, a digital BSA Membership Form will be emailed to the individual(s).
Transportation
                                                Checklist
                                                The safety of our Scouts, volunteers, employees, and communities
                                                is our top priority. This two part SAFE Transportation Checklist and
                                                Pre-Trip Transporting Inspection is designed to help you manage
                                                the risks associated with transporting Scouts.

Date: _____________________ Destination: _________________________________________________________________________________

Supervision—Youth are supervised by qualified and trustworthy adults who set the example for safety.
   Two-deep leadership for duration of trip

Assessment—Activities are assessed for risk during planning.
   Route is planned.
   Passenger list is planned for trip, both to and from destination.
   Breaks are planned.
   Drive time is no more than 10 hours within a 24-hour period.
   Meets or exceeds vehicle liability insurance minimums.
   Passengers have seats with factory-installed seat belts.
   Weather/environment contingencies and communications are planned.
   If operating a 15-passenger van, manufacture date is after 2005.

Fitness and Skills—Leaders have prerequisite fitness and skill to operate vehicle.
   Driver Annual Health and Medical Records are reviewed.
   Driver is an adult, age 18 or over.
   Driver has a valid driver’s license, a commercial license if applicable.
   Driver understands expectation to follow all applicable traffic laws.
   Driver is rested and not fatigued.
   Driver meets training requirements to operating vehicle.

Equipment and Environment—Safe and appropriate vehicle for Scouting trip. Leaders Inspect vehicles
and monitor the environment for changing conditions.
   Vehicle inspection completed.
   Tires on each vehicle are no more than 6 years old.
   Weather forecast and conditions.
   Communication plan.

If there are any incidents:
1. Take care of the injured/find a safe place.
2. Preserve and document the evidence. Take photos if appropriate.
3. Immediately complete an incident report and notify your local council.
   For more information, go to www.scouting.org/health-and-safety/incident-report/.

Resources
Guide to Safe Scouting: https://www.scouting.org/health-and-safety/gss/
SAFE: https://www.scouting.org/health-and-safety/safe/

                                                                                                                                680-696
                                                                                                                       May 2021 Revision
Pre-Trip
                                                Transportation Inspection
                                                Motor vehicles used to transport Scouts must complete
                                                Pre-Trip Transportation Inspection before travel for each
                                                driver and vehicle. This includes correcting all deficiencies.
                                                Make copies for additional drivers and vehicles.

Driver’s Information
Driver’s License Number: ______________________________ Driver’s Phone Number: ______________________________________

Vehicle Information
Make and Model: ______________________________________________________ Year: ______________________________________
  Inspection Current             Registration Current              Insurance Current               Vehicle Inspection

Vehicle Inspection
                      Visual Inspection                       Driver Adjustments                            Operational Test
                         Cleanliness                             Pedals                                          Defrost
                         Fluid Leaks                             Steering Wheel                                  Horn
                         Loose Parts                             Mirrors                                         Brakes

                      Light Inspection                        Engine Inspection                             Tire Inspection
                         Headlights                               Oil                                            Tire Pressure
                         Brake Lights                             Radiator                                       Uneven Wear
                         Turn Signals                             Battery                                        Tread Depth
                         Emergency Flasher                        Exhaust                                        Spare Tire

Trailer Inspection
Trailer Gross Vehicle Weight: ____________________________________Trailer Tongue Weight: ________________________________
Vehicle Towing Capacity: _________________________________ Vehicle Max Tongue Weight: ________________________________
   Vehicle has capacity to pull trailer?
   Trailer overall visual inspection?
   Towing ball correct size?
   Safety chains connected?
   Trailer breakaway connected?
   Lights properly working, including taillights, clearance lights, brake lights, directional signals, hazard lights, reflectors?
   Tire inspection, including spare?
   Trailer’s load is properly secured?

Commercial Driver’s License (CDL)
   Driver meets CDL requirements, including valid CDL, medical card, and drug testing program?
   Vehicle meets all federal and state CDL requirements, including IFTA and electronic trip logs?
   Pro-Trip vehicle walk-around complete by CDL standards?

Emergency
   Passengers have seats with factory installed seat belts?
   Triangle reflectors and flares?
   First-aid kit and fire extinguisher?
   Emergency water, food, blankets?
   Incident reporting forms?
   Form of communication?
                                                                                                                                          680-696
                                                                                                                                 May 2021 Revision
BSA Pre-Event Medical Screening Checklist
This is a tool to help leaders identify potentially communicable diseases in advance of event participation. The intent of this
checklist is to review with each participant their current health status both before departure and upon arrival at the event.*

   Name: _________________________________ Date/Event: ____________________________________
   Unit: ___________________________________ Campsite: _____________________________________

Do not participate if you have any of the following symptoms in the past 24 hours:

❏ Fever (100.4° F or greater)
❏ Vomiting
❏ Diarrhea
❏ New cough

Do not participate if you or anyone you live with has recently tested positive for COVID-19 or does not have test results back.
If you have a positive COVID-19 test, follow the CDC guidance for isolation and your personal health care provider’s
treatment recommendations.
Be responsible for your health and that of others. Isolate if you are sick. Do not attend any activity/meeting/event if you,
anyone you live with or anyone you have recently been around feel unwell. Symptoms might include:

❏ Unexplained extreme fatigue
❏ Unexplained muscle aches
❏ New rash
❏ Sore throat
❏ Open sore

                     Participants who are symptomatic or ill should not attend or return to an activity
                                        until cleared by their health care provider.

     *Councils are encouraged to customize this checklist with the engagement of local health authorities and their Council Health Supervisor.

                                                                                                                                          680-102
                                                                                                                                     2022 Revision
Part A: Informed Consent, Release Agreement, and Authorization                                                                                                                                                   A
Full name: ___________________________________________                                                                       High-adventure base participants:
                                                                                                                             Expedition/crew No.: _______________________________________________
Date of birth: _________________________________________                                                                     or staff position:___________________________________________________

Informed Consent, Release Agreement, and Authorization

I understand that participation in Scouting activities involves the risk of personal injury, including          I also hereby assign and grant to the local council and the Boy Scouts of America, as well as their
death, due to the physical, mental, and emotional challenges in the activities offered. Information             authorized representatives, the right and permission to use and publish the photographs/film/
about those activities may be obtained from the venue, activity coordinators, or your local council.            videotapes/electronic representations and/or sound recordings made of me or my child at all
I also understand that participation in these activities is entirely voluntary and requires participants        Scouting activities, and I hereby release the Boy Scouts of America, the local council, the activity
to follow instructions and abide by all applicable rules and the standards of conduct.                          coordinators, and all employees, volunteers, related parties, or other organizations associated
                                                                                                                with the activity from any and all liability from such use and publication. I further authorize the
In case of an emergency involving me or my child, I understand that efforts will be made to                     reproduction, sale, copyright, exhibit, broadcast, electronic storage, and/or distribution of said
contact the individual listed as the emergency contact person by the medical provider and/or                    photographs/film/videotapes/electronic representations and/or sound recordings without limitation
adult leader. In the event that this person cannot be reached, permission is hereby given to the                at the discretion of the BSA, and I specifically waive any right to any compensation I may have for
medical provider selected by the adult leader in charge to secure proper treatment, including                   any of the foregoing.
hospitalization, anesthesia, surgery, or injections of medication for me or my child. Medical
providers are authorized to disclose protected health information to the adult in charge, camp                  Every person who furnishes any BB device to any minor, without the express or implied permission
medical staff, camp management, and/or any physician or health-care provider involved in                        of the parent or legal guardian of the minor, is guilty of a misdemeanor. (California Penal Code
providing medical care to the participant. Protected Health Information/Confidential Health                     Section 19915[a]) My signature below on this form indicates my permission.
Information (PHI/CHI) under the Standards for Privacy of Individually Identifiable Health Information,
45 C.F.R. §§160.103, 164.501, etc. seq., as amended from time to time, includes examination
findings, test results, and treatment provided for purposes of medical evaluation of the participant,           I give permission for my child to use a BB device. (Note: Not all events will include BB devices.)
follow-up and communication with the participant’s parents or guardian, and/or determination of
the participant’s ability to continue in the program activities.                                                    Checking this box indicates you DO NOT want your child to use a BB device.

(If applicable) I have carefully considered the risk involved and hereby give my informed consent                                 NOTE: Due to the nature of programs and activities, the Boy Scouts of
for my child to participate in all activities offered in the program. I further authorize the sharing                             America and local councils cannot continually monitor compliance of program
of the information on this form with any BSA volunteers or professionals who need to know of                                      participants or any limitations imposed upon them by parents or medical
medical conditions that may require special consideration in conducting Scouting activities.                                      providers. However, so that leaders can be as familiar as possible with any
                                                                                                                                  limitations, list any restrictions imposed on a child participant in connection with
With appreciation of the dangers and risks associated with programs and activities, on my                                         programs or activities below.
own behalf and/or on behalf of my child, I hereby fully and completely release and waive
any and all claims for personal injury, death, or loss that may arise against the Boy Scouts                    List participant restrictions, if any:                                  None
of America, the local council, the activity coordinators, and all employees, volunteers,
related parties, or other organizations associated with any program or activity.                                ________________________________________________________

  I understand that, if any information I/we have provided is found to be inaccurate, it may limit and/or eliminate the opportunity for participation in any event or activity. If I am participating at
  Philmont Scout Ranch, Philmont Training Center, Northern Tier, Sea Base, or the Summit Bechtel Reserve, I have also read and understand the supplemental risk advisories, including height
  and weight requirements and restrictions, and understand that the participant will not be allowed to participate in applicable high-adventure programs if those requirements are not
  met. The participant has permission to engage in all high-adventure activities described, except as specifically noted by me or the health-care provider. If the participant is under the age of 18, a
  parent or guardian’s signature is required.

  Participant’s signature: ____________________________________________________________________________________________ Date: ______________________________

  Parent/guardian signature for youth: __________________________________________________________________________________ Date: ______________________________
                                                                                        (If participant is under the age of 18)

Complete this section for youth participants only:
Adults Authorized to Take Youth to and From Events:

You must designate at least one adult. Please include a phone number.

Name: _________________________________________________________________                                         Name: _________________________________________________________________

Phone: _________________________________________________________________                                        Phone: _________________________________________________________________

Adults NOT Authorized to Take Youth to and From Events:

Name: _________________________________________________________________                                         Name: _________________________________________________________________

Phone: _________________________________________________________________                                        Phone: _________________________________________________________________

                                                                                                                                                                                                                 680-001
                                                                                                                                                                                                             2019 Printing
Part B1: General Information/Health History                                                                                                                                 B1
Full name: ___________________________________________                                                          High-adventure base participants:
                                                                                                                Expedition/crew No.: _______________________________________________
Date of birth: _________________________________________                                                        or staff position:___________________________________________________

Age: ____________________________ Gender: __________________________ Height (inches): ___________________________ Weight (lbs.): ____________________________

Address: _________________________________________________________________________________________________________________________________________

City: ___________________________________________State: ____________________________ ZIP code: __________________                         Phone: ______________________________

Unit leader: ____________________________________________________________________________ Unit leader’s mobile #: _________________________________________

Council Name/No.: _______________________________________________________________________________________________________Unit No.: ____________________

Health/Accident Insurance Company: ________________________________________________________ Policy No.: ___________________________________________________

        Please attach a photocopy of both sides of the insurance card. If you do not have medical insurance, enter “none” above.

In case of emergency, notify the person below:

Name: ______________________________________________________________________________Relationship: ___________________________________________________

Address: _________________________________________________________________ Home phone: _________________________ Other phone: _________________________

Alternate contact name: _________________________________________________________________ Alternate’s phone: ______________________________________________

Health History
Do you currently have or have you ever been treated for any of the following?
  Yes      No                                 Condition                                                                             Explain
                  Diabetes                                                              Last HbA1c percentage and date:                            Insulin pump: Yes   No

                  Hypertension (high blood pressure)
                  Adult or congenital heart disease/heart attack/chest pain (angina)/
                  heart murmur/coronary artery disease. Any heart surgery or
                  procedure. Explain all “yes” answers.
                  Family history of heart disease or any sudden heart-related
                  death of a family member before age 50.
                  Stroke/TIA

                  Asthma/reactive airway disease                                        Last attack date:

                  Lung/respiratory disease

                  COPD

                  Ear/eyes/nose/sinus problems

                  Muscular/skeletal condition/muscle or bone issues

                  Head injury/concussion/TBI

                  Altitude sickness

                  Psychiatric/psychological or emotional difficulties

                  Neurological/behavioral disorders

                  Blood disorders/sickle cell disease

                  Fainting spells and dizziness

                  Kidney disease

                  Seizures or epilepsy                                                  Last seizure date:

                  Abdominal/stomach/digestive problems

                  Thyroid disease

                  Skin issues

                  Obstructive sleep apnea/sleep disorders                               CPAP: Yes      No

                  List all surgeries and hospitalizations                               Last surgery date:

                  List any other medical conditions not covered above

                                                                                                                                                                                 680-001
                                                                                                                                                                             2019 Printing
Part B2: General Information/Health History                                                                                                                                                         B2
Full name: ___________________________________________                                                          High-adventure base participants:
                                                                                                                Expedition/crew No.: _______________________________________________
Date of birth: _________________________________________                                                        or staff position:___________________________________________________

Allergies/Medications
DO YOU USE AN EPINEPHRINE                     YES         NO                                              DO YOU USE AN ASTHMA RESCUE                     YES        NO
AUTOINJECTOR? Exp. date (if yes) ___________________________                                              INHALER? Exp. date (if yes) ___________________________________

Are you allergic to or do you have any adverse reaction to any of the following?

  Yes      No         Allergies or Reactions                            Explain                        Yes      No           Allergies or Reactions                                  Explain

                   Medication                                                                                            Plants

                   Food                                                                                                  Insect bites/stings

List all medications currently used, including any over-the-counter medications.
    Check here if no medications are routinely taken.                                If additional space is needed, please list on a separate sheet and attach.

                   Medication                             Dose                     Frequency                                                              Reason

     YES        NO          Non-prescription medication administration is authorized with these exceptions: ________________________________________________________________
Administration of the above medications is approved for youth by:
_______________________________________________________________________ / _______________________________________________________________________
                                      Parent/guardian signature                                                      MD/DO, NP, or PA signature (if your state requires signature)

           Bring enough medications in sufficient quantities and in the original containers. Make sure that they are NOT expired, including inhalers and EpiPens. You SHOULD NOT STOP taking
           any maintenance medication unless instructed to do so by your doctor.

Immunization
The following immunizations are recommended. Tetanus immunization is required and must have been received within the last 10
years. If you had the disease, check the disease column and list the date. If immunized, check yes and provide the year received.          Please list any additional information about your
                                                                                                                                           medical history:
  Yes      No        Had Disease                           Immunization                                   Date(s)
                                                                                                                                           _________________________________________
                                      Tetanus
                                                                                                                                           _________________________________________
                                      Pertussis
                                                                                                                                           _________________________________________
                                      Diphtheria
                                                                                                                                           _________________________________________
                                      Measles/mumps/rubella

                                      Polio                                                                                                 DO NOT WRITE IN THIS BOX.
                                                                                                                                            Review for camp or special activity.
                                      Chicken Pox
                                                                                                                                            Reviewed by: ___________________________________________
                                      Hepatitis A
                                                                                                                                            Date: _________________________________________________
                                      Hepatitis B
                                                                                                                                            Further approval required:       Yes               No
                                      Meningitis
                                                                                                                                            Reason: _______________________________________________
                                      Influenza
                                                                                                                                            Approved by:____________________________________________
                                      Other (i.e., HIB)
                                                                                                                                            Date: _________________________________________________
                                      Exemption to immunizations (form required)

                                                                                                                                                                                                        680-001
                                                                                                                                                                                                    2019 Printing
Part C: Pre-Participation Physical
This part must be completed by certified and licensed physicians (MD, DO), nurse practitioners, or physician assistants.
                                                                                                                                                                                                       C
Full name: ___________________________________________                                                              High-adventure base participants:
                                                                                                                    Expedition/crew No.: _______________________________________________
Date of birth: _________________________________________                                                            or staff position:___________________________________________________

           You are being asked to certify that this individual has no contraindication for participation in a Scouting experience. For individuals who will be attending a high-adventure program,
           including one of the national high-adventure bases, please refer to the supplemental information on the following pages or the form provided by your patient. You can also visit
           www.scouting.org/health-and-safety/ahmr to view this information online.

Please fill in the following information:
                                              Yes    No                                                                         Explain

 Medical restrictions to participate

  Yes      No         Allergies or Reactions                            Explain                           Yes      No        Allergies or Reactions                              Explain

                    Medication                                                                                            Plants

                    Food                                                                                                  Insect bites/stings

           Height (inches)                           Weight (lbs.)                                 BMI                                Blood Pressure                                 Pulse
                                                                                                                                                /

                           Normal         Abnormal         Explain Abnormalities                Examiner’s Certification
                                                                                                I certify that I have reviewed the health history and examined this person and find no contraindications for
 Eyes                                                                                           participation in a Scouting experience. This participant (with noted restrictions):

                                                                                                   True         False                                           Explain
 Ears/nose/throat
                                                                                                                        Meets height/weight requirements.

 Lungs                                                                                                                  Has no uncontrolled heart disease, lung disease, or hypertension.
                                                                                                                        Has not had an orthopedic injury, musculoskeletal problems, or orthopedic
                                                                                                                        surgery in the last six months or possesses a letter of clearance from his or her
 Heart                                                                                                                  orthopedic surgeon or treating physician.
                                                                                                                        Has no uncontrolled psychiatric disorders.
 Abdomen
                                                                                                                        Has had no seizures in the last year.

                                                                                                                        Does not have poorly controlled diabetes.
 Genitalia/hernia
                                                                                                                        If planning to scuba dive, does not have diabetes, asthma, or seizures.

 Musculoskeletal
                                                                                                Examiner’s signature: _______________________________________ Date: _______________

 Neurological                                                                                   Examiner’s printed name: _________________________________________________________

                                                                                                Address: _______________________________________________________________________
 Skin issues
                                                                                                City: ______________________________________State: ______________ ZIP code: _________
 Other                                                                                          Office phone: ___________________________________________________

Height/Weight Restrictions
If you exceed the maximum weight for height as explained in the following chart and your planned high-adventure activity will take you more than 30 minutes away from an emergency vehicle/
accessible roadway, you may not be allowed to participate.
Maximum weight for height:

   Height (inches)            Max. Weight             Height (inches)             Max. Weight              Height (inches)           Max. Weight                 Height (inches)           Max. Weight
          60                        166                      65                       195                          70                     226                             75                   260
          61                        172                      66                       201                          71                     233                             76                   267
          62                        178                     67                        207                          72                     239                             77                   274
          63                        183                     68                        214                          73                     246                             78                   281
          64                        189                     69                        220                          74                     252                      79 and over                 295

                                                                                                                                                                                                      680-001
                                                                                                                                                                                                  2019 Printing
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