Intake

1

Household / Family Name* This field is required.

2

Scout's Name — Full Name field (First / Last), required.* This field is required.

3

Additional Scouts in Family

4

Parent/Guardian(s)* This field is required.

5

Authorized Pickup / Drop-off (Other than the parents/guardians above, these are the only adults permitted to take your Scout to/from activities.)

6

Who is attending events (this gives us a headcount for planning purposes)* This field is required.

7

Medical Flag — Does anyone attending have an allergy or medical condition leaders should be aware of? This is a heads-up flag only so leaders can plan and respond. Full medical details belong on the BSA health form.* This field is required.

Yes

No

8

Please give a brief description

9

Dietary needs for planning* This field is required.

Yes

No

10

Configurable list* This field is required.