Unit Swim Check Roster

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1 Unit Swim Check Roster Troop/Pack: District (circle one): Twin Rivers River Valley Lakeland Scoutmaster/Cubmaster Name: Scoutmaster/Cubmaster Signature Date Please check the appropriate box for each person, Swimmer, Beginner or Non-Swimmer. An example is provided. Name Please print legibly Swim Check Date Swimmer Beginner Non- Swimmer Super Scouter X BSA Swimmers Test: Jump feet first into the water overhead and swim 3 laps of 25 yards each lap using any stroke, 1 lap of 25 yards using the elementary backstroke and float motionless on their back for one minute without sinking. BSA Beginners Test: Jump feet first into water overhead, surface and swim 25 feet with a strong stroke, turn around and swim 25 feet back to the starting point.

2 Unit Roster This unit Roster form is provided for your convenience. You may use this form or provide your own roster. The roster must include all YOUTH and ADULTS attending camp and their telephone numbers. Please present this form at check-in. Troop/Pack: District (circle one): Twin Rivers River Valley Lakeland Campsite: ADULT LEADERS Name (First, Last) Dates in Camp Mobile # Position YOUTH Name (First, Last) Phone # Name (First, Last) Phone # Each Unit MUST bring 3 copies of this roster to camp.

3 Provisional Scout Registration A provisional camper is an excellent way for youth to attend camp even if their unit is not in camp. Scouts attending as a provisional camper, will be paired with a unit in camp so that they can participate in all troop activities and achieve their individual goals at camp. All fees mush be turned into the Scout Office no later than two weeks prior to their camping session. I would like to attend Ingawanis Adventure Base this summer, however I cannot go with my unit. Please sign me up for a week circled below. Boy Scout Week #1 June 21-27, 2015 Boy Scout Week #2 June 28 - July 4, 2015 Boy Scout Week #3 July 12-18, 2015 Provisional Scout fee is $ with the first $ due by March 31 st. The remaining $ is to be paid by May 1 st. Once fees are received, scouts can register for merit badges. Provisional Campers should check into the Directors Lodge no later than 2:30 on the Sunday of their scheduled week. A completed health form must be present at check-in. PLEASE PRINT CLEARLY Name: Troop Street Address: City: State: Zip: Phone Number: Signature of Parent: Name of Unit Leader: Signature of Unit Leader: Merit Badge Choices: Choice Number 1: Choice Number 2: Choice Number 3: Choice Number 4:

4 Winnebago Council Campership Application Form NOTICE: This completed Nomination for Campership form must be returned to the Council Office. Winnebago Council Service Center, 2929 Airport Blvd. Waterloo, Iowa Camperships are only for use in Winnebago Council Resident Camps (Cub Resident, Webelos Resident, and Boy Scout Resident). Only one scout per application. It is important that all Scouts have an opportunity to attend Summer Camp. Each Unit Committee has the responsibility to provide opportunities for all boys to earn their way to Summer Camp. When family finances and unit money-earning opportunities cannot provide sufficient funds to cover these fees, the Winnebago Council makes Camperships available to help these Scouts attend camp. Unit Committees nominate boys by submitting a Nomination for Campership form to the Council Service Center. Additional copies of this form can be reproduced or obtained from the Service Center. Adults will not be award camperships. NOTICE: Unit Committees should cooperate in nominating Webelos transitioning to Boy Scout Troops. Funds earned by the boy in the Pack should follow that boy to support his first Boy Scout Summer Camp opportunity. The Council Campership Committee reviews the nominations and may contact the Unit Committee for additional information to help review the form. The Council Campership Committee reviews all allocates available resources on the basis of need. Therefore, camperships will be awarded as funds are available. Please be sure to the information requested below and on the next page is complete and accurate. Please share as much information as possible for your nominee s need for the campership. All Scouts deserve to attend camp. It is understood that the combined family and unit provisions of funds will amount at least one-half of the fees for camp. District (circle one): Twin Rivers River Valley Lakeland Troop/Crew Number: Scout Name: Age: Rank: Number of Years in Unit: Number of Years Attended Camp: Camp Session Dates: Amount of Request (calculation on next form) $ NOTICE: The nomination is for the current year only. The parent/guardian and either the Scoutmaster OR Unit Committee Chair mush sign for this request to be processed. Parent/Guardian Name: Phone Number: Address: City: State: Zip: Unit Leader: Phone Number: Date: Committee Chair: Phone Number: Date: Forms must be returned to the Council Service Center no later than March 2 nd for time to review.

5 Winnebago Council, Boy Scouts of America Worksheet for Campership Request Name: Unit Number: All blanks must be filled in for this application to be considered. Total fee for Resident Camp Amount Scout or Family is able to pay Amount provided by unit money-earning opportunities (i.e. Popcorn) Total provided by family and unit (line b plus line c) Total Campership request (line a minus line d) (a) $ (b) $ (c) $ (d) $ (e) $ ALL INFORMATION IS CONFIDENTIAL Approximate Family Income: Circumstances (use additional page if necessary) WINNEBAGO COUNCIL USAGE ONLY Unit Information: Circle all the unit participated in: Quality Unit Family FOS Popcorn Sale Candy Sale Application for: Reviewed on: Amount of Request: $ Disapproved due to: Funds made available by the council have been depleted Application received after the deadline Other (explain): Signed: Council Camping Committee Chair

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