LOCAL TOUR PERMIT APPLICATION (front)

Boy Scout of America
LOCAL TOUR PERMIT APPLICATION
For Trips and Camps Under 500 Miles
LOCAL PERMIT NO._______________________ DATE ISSUED______________________

This application must be filed with local council service center 2 weeks in advance of scheduled activity for proper clearance. It is used for trips of less than 500 miles. If destination is 500 miles or more one way or outside the U.S.A. (local council camp excepted), use National Tour Permit Application, No. 34419. If backcountry trip, be sure to know BSA Wilderness Use Policy.

Type of Unit ___________ No. _________ Town______________________ District_____________________________ hereby applies for a permit and submits plans herewith for a trip from___________________, 19____, to ___________________, 19____.

Give itinerary if tour, or destination if camp, including route description for reaching campsite (for long trip attach map indicating route and overnight stops):
____________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________

Type of trip: One day Touring camp Short-term camp Long-term camp (Furnish copy of program and menus.)
Will there be aquatic activities? ______________ Does adult (21+) leader have Safe Swim Defense certification? ______________
Name of person in group with current water safety certification ______________________ Age ____Type of Certification _________________
If boating activities are planned, we will use Safety Afloat, No. 7368 ____________________________________________________________

Mode of transportation: Car RV Van Bus Boat Canoe Train Hiking Truck Other __________________________
(The beds of trucks and camper trucks are approved for equipment only -- passengers are allowed only in the cab.)

Tour will include ______ youth and ______ adults. Have parents' approval been secured? ____________________________________________

It is the tour leader's and unit committee member's understanding that all drivers, vehicles, and insurance coverages will meet the national requirements as listed on the reverse side of this application. The Boy Scouts of America policy requires two adult leaders on all camping trips and tours. Tour leader in charge must be at least 21 years of age.

Tour leader's name _________________________________________________________ Age _________ Phone _____________________

Address____________________________________________________________________________________________________________

Assistant tour leader's name ___________________________________________________ Age _________ Phone _____________________

Address____________________________________________________________________________________________________________

________________________________	________________________________
Signed by member of unit committee	Signed by tour leader

RETAIN IN COUNCIL SERVICE CENTER — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — —
COMPLETE AND RETURN TO UNIT

OFFICIAL LOCAL TOUR OR CAMP PERMIT BOY SCOUTS OF AMERICA

This permit should be in the possession of group leader at all times and displayed when requested by Scouting officials or other duly authorized persons.

Permit issued to ___________________ No. _____ Town ______________________________________

___________________________________________________________________________________________________
Name of tour leader                                                                      Age                                                             Address

___________________________________________________________________________________________________
Assistant tour leader                                                                    Age                                                             Address

Permit covers all travel between ________________ and _____________________
Dates of trip from _______________, 19______, to ________________, 19______
Total youth __________________ Total adults _____________________________
This group has given the local council every assurance that they will conduct themselves according to the best standards of Scouting and observe all rules of health, safety, and sanitation as prescribed by the Boy Scouts of America and as stated in the Pledge of Performance on the reverse side of this permit.

These spaces are for the signatures and comments of officials where the group camps or stays for 1 night or more. Signatures indicate that the cooperation and conduct of the Cub Scout, Boy Scout, Varsity Scout, or Explorer group were satisfactory in every way.

Date______Place_____________Signature________________Comment__________________________

Not official unless council stamp appears here.

_____________________________
Council Name and Address
_____________________________
Council Phone No.
_____________________________
Signed for the council