CAMP HUNT - #WEOWNADVENTURE - Crossroads of the West Council, BSA
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CAMP HUNT
2020
SCOUT
CAMP
#WEOWNADVENTURETable of Contents
Introduction to Camp .............................................................4
Contact Us......................................................................................................4
Non-Discrimination Clause............................................................................4
PROGRAM OPPORTUNITIES ..........................................5
Flag Ceremonies .............................................................................................5
Troop Service Projects....................................................................................5
Leader’s Training ...........................................................................................5
Campsite Inspections (See Attached Form) ....................................................6
Campfires .......................................................................................................6
Swimming .......................................................................................................6
Boating ...........................................................................................................6
Polar Bear Society ..........................................................................................6
Washakie Games ............................................................................................7
Nature Area And Trail ...................................................................................7
Archery Range ...............................................................................................7
Mile Swim ......................................................................................................7
Rank Advancement .................................................................8
Advancement Policies .....................................................................................8
First Year Camper Program ...........................................................................9
Merit Badge Program .....................................................................................9
Class Time Offerings ......................................................................................9
Merit Badge Preparation ..............................................................................10
Preparing for Adventure .......................................................12
Pre-Camp Checklist .....................................................................................12
PAGE 1Food Service ..........................................................................13
Dietary Accommodations .............................................................................13
Dining Hall ...................................................................................................13
Commissary ..................................................................................................13
Bring Your Own Food ..................................................................................14
General Information .............................................................15
Medical Forms ..............................................................................................15
Refund Policy ...............................................................................................15
Insurance ......................................................................................................15
Swim Check..................................................................................................15
Leadership Roles ..........................................................................................15
Special Needs Requests ................................................................................16
Campsite Accommodations..........................................................................16
First Aid ........................................................................................................16
Youth Protection ...........................................................................................16
Emergency Alarm ........................................................................................16
Buddy System ...............................................................................................16
Ecology .........................................................................................................17
Tree Climbing ..............................................................................................17
Hammocks....................................................................................................17
Fire................................................................................................................17
Ax Yard and Wood Cutting..........................................................................17
Uniforms ......................................................................................................17
Firearms, Ammunition & Archery ...............................................................18
Courtesy .......................................................................................................18
Quiet Hours .................................................................................................18
Smoking, Alcohol & Drugs ...........................................................................18
PAGE 2Lost Camper Prevention ..............................................................................18
Facilities and Equipment ..............................................................................19
Phone............................................................................................................19
Trading Post .................................................................................................19
Showers & Restrooms ...................................................................................20
Packing List ..................................................................................................20
PAGE 3Introduction to Camp
Tucked neatly amid a grove of cottonwood, river birch, maple, and pine trees on
the shores of Bear Lake, Camp Hunt is all about aquatics!
Camp Hunt is located on the west shore of Bear Lake 2 miles north of Garden
City, Utah. The camp features renovated/new facilities including: docks, and
shower facilities.
Contact Us
We’re here to help your unit have the most memorable experience at camp. If you
have any questions as you prepare for your adventure, please let us know at
program.office@scouting.org or camphunt@scouting.org.
Non-Discrimination Clause
Bartlett Scout Reservation does not discriminate against anyone on the basis of
race, color, national origin, religion, age, sex, handicap, or any other delineation of
peoples.
PAGE 4PROGRAM
OPPORTUNITIES
Along with the great location and staff at Camp Hunt, 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 songs, cheers, 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.
Troop Service Projects
If desired, we provide opportunities for your Unit to do service projects while in
camp. Many Troops feel this is an important part of their summer camp
experience. Projects can range from very simple to more complex. Often adults
with special talents can do more intricate and exacting work. The camp will tailor
projects to your Troops’ age and skill. We are always looking for people who would
like to help Camp Hunt 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, Safe
Swim Defense and Safety Afloat cards.
PAGE 5Campsite Inspections (See Attached Form)
Campsites will be inspected each day by the 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 Hunt’s fabulous fire bowl overlooking Bear Lake. 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.
Swimming
Camp Hunt has a great swimming area, operated in strict accordance with BSA
policies and is used for general swims during free time, merit badge classes, and
rank advancement instruction. Don’t forget the mile swim. A mile in Bear Lake
will give you bragging rights for life!!!
Boating
Camp Hunt provides canoes, stand up paddle boards and kayaks. These are
available for use during all free time sessions. Come on down and enjoy!! This is a
great opportunity for Scouts and leaders to practice their boating skills or just have
fun. Certified swimmers may use the canoes and kayaks. Everyone must use a
PFD. An orientation and demonstration of ability is required to use equipment.
Please remember that all persons on the water are responsible for their actions and
care must be taken to ensure safety.
Polar Bear Society
This is a chance for Scouts to learn about nature by experiencing it! Membership
in the Camp Hunt Polar Bear Society is open to all campers who are able to fulfill
the requirements (learning ten plants, finding five animal signs, and taking a
refreshing dip in the early morning in Bear Lake).
PAGE 6Washakie Games
All Troops are invited to participate in games and skill activities conducted by the
staff on Tuesday evening. This is a chance to have a positive interaction with all
the other campers at Hunt and an opportunity to build team and scout spirit.
Nature Area And Trail
Camp Hunt offers many opportunities to discover and learn about our
environment. We offer a nature trail which is set up to be staff-led or self-guided.
How about a unique “Polar Bear Society” which allows scouts to really experience
nature with all their senses?
Archery Range
An archery range is available, and all participants receive safety orientation and
skill training. Arrows are provided.
Mile Swim
This is an individual activity. Participants will need another Troop member to
supervise and count laps, and will need to work with the Waterfront Director for
times, locations, and equipment to be utilized.
PAGE 7Rank Advancement
The primary responsibility for rank advancement is that of the unit leaders and the
unit committee. Camp Hunt 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 his handbook). Camp counselors will also sign merit
badge blue cards, but the Unit is responsible to ensure they are properly recorded
in each youth’s permanent record. Leaders will receive physical blue cards for any
free-time merit badges completed by their Scouts. For Merit Badge Classes (1, 2, &
3) all blue cards will be provided digitally. Instructions to retrieve digital blue cards
will be provided at check-out.
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 Hunt.
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 Hunt 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
cards to the Unit Advancement Chairman.
PAGE 8First Year Camper Program
The first year camper program at Camp Hunt 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. The activities
include:
1. Commando Corps - offers basic camp craft skills as well as wilderness
survival. (Tenderfoot 3a, 3b, 3c, 3d; 2nd Class 2f, 2g; 1st Class 3a, 3b,
3c, 3d)
2. Bay Watch - covers the basics of first aid and water safety and rescue.
(2nd Class 5a, 5b, 5c, 5d, 6a, 6b, 6c; 1st Class 6a, 6b, 6c, 6d, 6e, 7c)
3. Naturalist - gives campers a chance to learn the forest ecology & no
impact camping skills. (Tenderfoot 4a, 4b, 4c; 2nd Class 1b, 4, 6d, 6e; 1st
Class 1b, 5a, 5b, 5c, 5d)
4. Pathfinder - covers the basics of orienteering, map reading, and trail signs.
(2nd Class 3a, 3b, 3c, 3d; 1st Class 4a, 4b)
Merit Badge Program
The following is a list of merit badges offered at Camp Hunt. 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.
Class Time Offerings
• First Year Camper - Class hour #3
• Archery - Class hours #1, 2, 3
• Astronomy - Class hours #2, 3
• Orienteering - Class hours #2
• Personal fitness - Class hours #3
• Sports - Class hour #1
• Canoeing - Class hours #1, 2, 3
PAGE 9• Kayaking - Class hours #1, 2, 3
• Lifesaving - Class hours #3
• Swimming - Class hours #1, 2
• Emergency preparedness - Class hours #2, 3
• Environmental science - Class hours #1, 2, 3
• First aid - Class hours #1, 2
• Fish & wildlife - Class #3
• Forestry - Class #1, 3
• Indian lore - Class #3 ($)
• Leatherwork - Class #2 ($)
• Mammal study & Nature - Class #1,2
• Pioneering - Class #1
• Search and rescue - Class #2
• Wilderness survival - Class hours #1, 3
• Wood Carving - Class #1
DURING “FREE TIME” the Waterfront 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 and cooking merit badges are signed off by the Scout’s own Unit
Leaders.
Merit Badge Preparation
Some Merit Badges and the BSA Lifeguard award have requirements, which
cannot be completed in a week of summer camp. If your Scouts are interested in
finishing any of these at Camp Hunt, they should have completed the following
requirements before departing for Hunt:
• Life Saving - CPR training, 2nd Class 5A-5D, 1st Class 6a, bb and e. Know
front crawl, sidestroke breaststroke and elementary backstroke
PAGE 10• Nature - requirement #4
• Personal Fitness - requirements #8 and #9
• Search & Rescue - requirement #8b
• Sports - requirements #4 and #5
PAGE 11Preparing for Adventure
Pre-Camp Checklist
• 16 weeks before camp - Parent’s night conducted to inform parents of camp
plans
• Spring – Watch the camp broadcast leader orientation online
• 12 weeks - Leadership arranged, two-deep leadership at all times
• April 30 - 50% fees are due to Crossroads of the West Council
• May 1 - Online merit badge registration opens
• 8 weeks - Remind parents that all camp attendees need health forms
• 8 weeks - Scouts have personal equipment list
• 4 weeks - Health & medical record completed for each Scout & adult
• 4 weeks - All youth BSA registered (use attached roster)
• 4 weeks - Transportation arranged and insurance verified
• 4 weeks - Troop camping equipment ready
• 1 week - Final camp fee amount due and online merit badge registration ends
• 1 week - Unit roster verified at Council office
PAGE 12Food Service
It is our hope to serve you well while you’re at Camp Hunt. Our Staff is here to be
of assistance to you.
Dietary Accommodations
If you have special dietary needs while at camp, please submit the “Allergies At
Camp” form at least two weeks prior to your arrival. The form can be found at:
www.utahscouts.org/allergy. We are happy to do our best to meet your needs. The
camp cook will contact you prior to your arrival at camp to consult with you and
provide you with information about our menu and which accommodations will be
available. We cannot guarantee accommodations will be 100% free from cross-
contamination as all food is prepped in the same area, but we will do our best.
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: $6.60 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.
Commissary
This service provides food for your troop to prepare in your campsite. The troop is
responsible for providing their own cooking and eating utensils and supplies. Each
troop is also advised to bring their own coolers. This will allow for items such as
milk, eggs, and butter to remain cool while preparing food. Ice is available for
purchase in the commissary for $2 per bag. Reservations for guests must be made
and paid for in advance: $6.60 per meal.
Standard Supplies
The following will be supplied upon request:
• Printed Menu
• Paper towels
• Condiments:
PAGE 13• Butter
• Mustard
• Mayonnaise
• Ketchup
• Salt & pepper
• Jam/Jelly
• Peanut butter
• Bread
When you run out of any of the above items, please come to the commissary and
we will gladly issue you more. If you were issued a container, please bring it back
for a refill.
When you pick-up your meals, please compare the items in your box with the items
listed on the menu. If anything is missing or insufficient amounts, notify the
commissary staff immediately. Upon arrival at your campsite, please empty the
containers and return them promptly to the Commissary so we may begin filling
them again. This also includes your meal totes.
Bring Your Own Food
Simple: you bring it, you prepare it, and you store it. Food storage will be your
responsibility. Ice is available for purchase in the commissary for $2 per bag.
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.
PAGE 14General Information
Please understand that the purpose of camp rules is to ensure the safety and
convenience of all those who will be living together here at Camp Hunt. These
rules make it possible for us to safely do things we would otherwise never attempt.
In a very real sense, these rules set us free.
Medical Forms
All participants (youth & adults) must complete parts A, B & C of the BSA health
form. Bring these forms with you and turn them into the office upon check in.
Refund Policy
A complete list of required deposits, fee schedules, and information about refunds
is available online at www.utahscouts.org/refund.
Insurance
• Each group is required to carry adequate and proper liability insurance. Your
group will need to bring a copy of this policy when you arrive at camp.
• Please prepare to verify that each camper is protected with personal health
insurance - ensure that policy numbers are listed on each medical form.
Swim Check
Campers that plan to swim or participate in boating activities must take a swim
check. Units are encouraged to do their swim check prior to arriving at camp. If
you do complete a swim check prior to camp please note you will be asked to
complete a chill Check. The swim check will take place on Monday morning upon
arrival at camp.
Leadership Roles
All groups are required to maintain 2 adult leaders at camp during all times. One
additional adult is required for every 10 youth.
PAGE 15Special 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
Small units may need to share campsites with other groups. Each campsite has a
picnic table (or two) and a campfire pit. Campsites may share a water faucet
(potable).
First Aid
Our Health Lodge is designed to meet basic first aid needs of our participants. All
injuries must be reported and properly recorded. We are ready with emergency
support and will make necessary contact with the local Emergency Medical
Services if necessary. Our Health Office is equipped with a medicine fridge if
needed.
Youth Protection
The Boy Scouts of America is a leader in the fight against child abuse. We must do
everything in our power to prevent physical, emotional, and sexual abuse. To
protect youth and adults we must be extremely careful to follow the BSA TWO-
DEEP LEADERSHIP policies. The BSA cannot tolerate any activity that can, in
anyway, be interpreted as abusive. If you are aware of anything questionable,
please report it at once to the Camp Director. Do not become directly involved
unless there is an immediate physical threat.
Emergency Alarm
If you hear the alarm, walk to the parade grounds with your group, and ensure all
are accounted for. Further instructions will be presented at the parade grounds.
Buddy System
All campers should use the buddy system at ALL times in camp.
PAGE 16Ecology
Animal Conservation - 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. The vegetative life in this high mountain ecosystem is
very fragile. Please make every effort to stay on trails. Do not pick flowers or
collect specimens. When gathering firewood, collect only dead and down wood.
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.
Tree Climbing
Camp Hunt has a strict no tree climbing policy. Participants (youth or adult) that
are discovered to be climbing trees will be sent home.
Hammocks
Those that wish to use hammocks at camp must provide their own free-standing
frame. Hammocks are not allowed to be attached to trees. 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
allowed in camp. All fires must be confined to the designated fire pits in each
campsite.
Ax Yard and Wood Cutting
All woodcutting must be done in this area.
Uniforms
It is always appropriate to wear a uniform to any camp activity. It is especially
encouraged for inspections, flag ceremonies, and camp-wide activities.
PAGE 17Firearms, Ammunition & Archery
Camp Hunt has adequate equipment and so it is required that no personal
firearms, archery equipment or ammunition be brought to camp.
Courtesy
The campsite is your Troop home while at camp. Your Camp Friend and
Commissioner are near to assist you if necessary, but the Troop’s conduct while in
the site will be the unit adults’ responsibility. Please instruct your Scouts to respect
the other Scouts and Troop campsites. Do not enter them unless invited. Control
noise, respect quiet hours, and leave other people’s personal property alone.
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.
Smoking, Alcohol & Drugs
All buildings and tents are smoke-free. There are designated smoking areas for
those who smoke. As a facility of the Boy Scouts of America, possession or
consumption of alcoholic beverages is not permitted on the property. Possession of
unprescribed drugs, or abuse of prescribed drugs, are expressly prohibited at camp.
Individuals or groups found in violation of this policy will be sent home
immediately.
Lost Camper Prevention
One should never go where they do not know and one should always take a buddy.
Stay on trails, in camp, or with an experienced staff guide. No one should ever go
anywhere without telling unit leaders where they are going and when they intend to
return. Always be prepared with signaling device, water and food, proper clothing
and shelter.
PAGE 18Unit leadership should report immediately if someone does not show up when and
where they should. Please instruct all scouts and leaders to stop and stay put, “hug
a tree”, the moment they realize they are lost.
Facilities and Equipment
The Commissioner and Scoutmaster will conduct an inventory of all campsite
equipment when arriving in camp. Damage that may occur during the week will
be assessed to the Troop. Report any damage as soon as it is noticed.
Camp Hunt provides all Troops with the opportunity to avail themselves of literally
hundreds of thousands of dollars’ worth of program equipment during a week of
camp. Normal “wear and tear” of equipment is expected; however, careless or
intentional mistreatment of equipment is not permitted. All campers should take
care of, and have respect for, all camp wide equipment and facilities including: All
shower and restroom facilities, camp wide buildings and structures, personal camp
equipment belonging to others, program equipment.
Camp Hunt is proud of its equipment and facilities. All campers are politely asked
to use the equipment as intended and to have a great time in doing so.
Phone
There is no public phone available. If there is an emergency, there is an
“emergency only number” at camp. This is (801) 475-7485. Please use the Troop
number and name of anyone you are trying to reach when your call is placed.
Trading Post
Camp Hunt has a great store, which provides camp gear, snacks, souvenirs, and
program supplies. Some other items available are batteries, toiletries, soda, treats,
and camp memorabilia.
The average Scout will spend between $45 and $60 during their week between
Merit Badge supplies, snacks, and camp memorabilia.
PAGE 19Showers & Restrooms
The centralized shower house provides showers 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 everyone do their part to keep the showers
clean and safe. Adults should be aware of their Troops behavior and control
discipline by providing supervision while youth are in the shower. If there are any
difficulties with other campers; please contact the staff.
Troops who share the use of each facility are all responsible for cleaning it daily.
Health, safety and cleanliness are everyone’s responsibility.
Please put only paper waste in to the toilets - never any sanitary wipes or garbage.
Packing List
Please consult your Boy Scout handbook for a list of items to bring to camp. Other
resources include: http://boyslife.org/outdoors/outdoorarticles/6976/scout-
outdoor-essentials-checklist/
PAGE 20CAMP
HUNT Tr apper Trails Council
BLACK
FOOT (L) A R A PA H O ( M ) C O M A N C H E ( L ) CREE (S)
TO IDAHO A PA C H E ( M )
PA R K I N G
YUMA (L)
CHEYENNE (L)
BANNOCK (S)
NORTH
ENTRANCE
CHEROKEE (M)
PA R A D E G R O U N D S
PA R K I N G
HANDICRAFT
AREA A R C H E RY
AREA OLD
CHAPEL
HOPI (S)
FOX (M) N AT U R E
AREA CROW (S)
UTE (M)
GOSHUTE (S) SEMINOLE (S)
SIOUX (M)
OUTDOOR
SENECA (S) SKILLS N AVA J O ( L )
AREA TA O S ( L )
SAUK (M)
CAMP WIDE
SOUTH SERVICE GAMES AREA
ENTRANCE VEHICLES
WAT E R F R O N T
ONLY
LODGE AREA
B O AT
HOUSE
SHOSHONE (L)
PAW N E E ( M )
S H AW N E E ( S )
M O H AW K ( S )
K I O WA ( L )
TO GARDEN
CITY
ZUNI (M)
REILLEY FIELDCamp Hunt Week-at-a-Glance
Time Monday Tuesday Wednesday Thursday Friday Saturday
6:30 AM Sunrise Canoe Hike Sunrise Canoe Hike Polar Plunge Breakfast and
Bird Walk departure
7:30 Arrival at camp, Breakfast and camp Breakfast and camp Breakfast and camp Breakfast and camp
check-in and camp inspections inspections inspections inspections
set up.
Scoutmasters need
to come to the
8:30 Lodge to check in!
9:30 Flag Ceremony Flag Ceremony Flag Ceremony Flag Ceremony
10:00 First Merit Badge First Merit Badge First Merit Badge Merit Badge
Session Session Session Completion Time
11:00 Second Merit Badge Second Merit Badge Second Merit Badge
Session Session Session
12:00 PM Third Merit Badge Third Merit Badge Third Merit Badge
Session; First Year Session; First Year Session; First Year
Camper Commando Camper Naturalist Camper Baywatch
Corp
1:15 Lunch Lunch Lunch Lunch Lunch (Scoutmasters
in the lodge)
2:30 Swim checks & FREE TIME FREE TIME FREE TIME Waterfront Olympics
camp set up Free time merit Free time merit Free time merit @ Beach
continues badge work. badge work. badge work.
4:30 First Merit Badge
Session Waterfront open. Waterfront open. Waterfront open.
Troop shoots at Troop shoots at Troop shoots at
5:00 Second Merit Badge archery range. archery range. archery range.
Session
5:30 Third Merit Badge
Session; First Year
Camper Pathfinder
6:00 Dinner Dinner Dinner Dinner Dinner
7:00 Opening Campfire Troop Activities
preparations
7:30 Leaders Meeting Washakie Games Flag Ceremory;
with Senior Patrol Honor Trail
8:00 Leader 7:30 - 8:15 Flag Ceremony;
Closing Campfire
8:20 Camp-wide fire drill
8:30 Flag Ceremony; Flag Ceremony; Flag Ceremony and
Opening Campfire Fellowship of the Comissioner
Lake Guides' Campfire Programs
Induction Ceremony
10:30 Quiet Time Quiet Time Quiet Time Quiet Time Quiet Time
Please don't be late -- FOR ANYTHING. YOU'LL BE MISSING OUT!Swim Check Certification
Instructions:
• Complete 1 of the following:
• This form is to be used by units attending Scout Camps, High
✦ Swimmer test (S):
Adventure Bases, and Treks.
• Jump feet first into water over the head in depth, level off,
• Fill out the unit contact information, and list all participants that will
and begin swimming.
attend camp (youth & adults).
• Swim 75 yards in a strong manner using one or more of the
• The swim classification (swim check) is a key element of Safe Swim
following strokes: side, breast, trudgen, or crawl.
Defense & Safety Afloat. All persons participating in BSA aquatic
• Swim 25 yards using the elementary back stroke.
activities will be classified according to their swimming ability. The swim
• The 100 yards total must be done continuously and include
check allows individuals to demonstrate the minimum level of swimming
at least one sharp turn.
skill consistent with circumstances while in the water.
• After completing the test, rest by floating.
• The swim classification should be renewed annually. When swim
✦ Beginner test (B):
checks are conducted away from resident camp or at the point of
• Jump feet first into water over the head in depth, level off,
activity, the BSA certified aquatics director has the authority to review or
and begin swimming.
retest all participants to ensure standards have been maintained.
• Swim 50 yards on the surface, stop, turn sharply, and
• The swim check should take place in a maximum 12 foot depth body of
resume swimming as before.
water. During the swim check, the swimmer must be within 25 feet of
• Return to starting place.
shallow water footing or pool/pier edge.
✦ Non Swimmer (N):
• Administration of Swim Check: 1) Completed on the first day of resident
camp by aquatics personnel, 2) Completed on the unit level and Unit Leader Signature
conducted by a BSA aquatics instructor, aquatics supervisor, BSA
lifeguard, certified lifeguard, swimming instructor or coach, or unit
leader. Who performed your swim check? Circle one:
• Aquatics instructor, BSA lifeguard, certified lifeguard
• Swimming instructor, swim coach
• Swimming/Lifesaving merit badge counselor, unit leader
Unit # _________ Camp: _________________ Camp Date: _______________________
Unit Leader Name (First & Last): ___________________________________________________________
Mailing address: ________________________________________ City: ________________ State: _____
ZIP: ________________ Phone: ( ___ ) ________________ Email: ______________________________
Name Swim Class Name Swim Class Name Swim Class
_________________ S B N _________________ S B N _________________ S B N
_________________ S B N _________________ S B N _________________ S B N
_________________ S B N _________________ S B N _________________ S B N
_________________ S B N _________________ S B N _________________ S B N
_________________ S B N _________________ S B N _________________ S B N
_________________ S B N _________________ S B N _________________ S B N
_________________ S B N _________________ S B N _________________ S B N
_________________ S B N _________________ S B N _________________ S B N
_________________ S B N _________________ S B N _________________ S B N
_________________ S B N _________________ S B N _________________ S B N
_________________ S B N _________________ S B N _________________ S B N
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_________________ S B N _________________ S B N _________________ S B NPart 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 PrintingPart 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 PrintingPart 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 PrintingPart 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
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